The Effect of Varicocelectomy on Semen Analysis and Serum Levels of InhibinB

Background: Varicocele means dilation and torsion of spermatic veins. About 15%-40% of infertile men suffer from Varicocele. It seems that 70% of secondary infertility in men occurs due to Varicocele. Varicocele is the most common surgical cause for male infertility. Varicocelectomy is considered as the best treatment method for patients with Varicocele that increases 30%-50% of the postoperative fertility rate. The purpose of this study was to investigate the effect of Varicocelectomy on inhibin B and use this marker to predict infertility in men.Methods: In this study, all infertile patients in any age that were candidate for Varicocelectomy and hospitalized in Imam Hospital in Urmia were included. Exclusion criteria were defined as orchitis, trauma, diabetes, radiotherapy, chemotherapy and coitus complications. Sperm analysis (SA) was conducted three times for patients and then serum levels of FSH, LH, T, inhibin B, SA were measured before surgery and also six months after surgery. Furthermore, during the hospitalization and infertility period, testes were examined before surgery in terms of consistency and size.Results: The mean ± SEM (standard error median) age of 40 patients was 28.4±5.14 (range: 18-40) years old. Mean size of the testes and mean sperm density and serum levels of LH.FSH remained the same. However, mean sperm motility, serum levels of T and inhibin B were statistically significant after the Varicocelectomy (p-value=0.005). A significant relationship was found between serum levels of inhibin B and infertility; however, there was no significant relationship between sperm count and serum levels of LH, FSH and T. Varicocelectomy can improve sperm motility and increase Inhibin B in patients and so improves spermatogenesis parameters and it may be one of the causes of fertility in patients.Conclusion: The results of this study indicate that sperm motility and increase in inhibin B after Varicocelectomy can improve spermatogenesis parameters. Serum levels of FSH, T, LH and sperm morphology and also grade of Varicocele, patient age, and testis size have no effect on spermatogenesis and fertility after Varicocelectomy.

M. leprae inhibits apoptosis in THP-1 cells by downregulation of Bad and Bak and upregulation of Mcl-1 gene expression

BACKGROUND: Virulent Mycobacterium leprae interfere with host defense mechanisms such as cytokine activation and apoptosis. The mitochondrial pathway of apoptosis is regulated by the Bcl-2 family of proteins. Expression of Fas ligand and apoptotic proteins is found in leprosy lesions and M. leprae has been shown to activate pro-apoptotic Bcl-2 genes, Bak and Bax. However, the mechanism by which M. leprae modulates apoptosis is as yet unclear. We investigated expression of apoptotic genes in THP-1 monocytes in response to infection by M. leprae and non-pathogenic M. bovis BCG. RESULTS: M. leprae did not induce apoptosis in THP-1 cells, while BCG induced a significant loss of cell viability by 18 h post-infection at both (multiplicity of infection) MOI-10 and 20, with an increase by 48 h. BCG-induced cell death was accompanied by characteristic apoptotic DNA laddering in cells. Non-viable BCG had a limited effect on host cell death suggesting that BCG-induced apoptosis was a function of mycobacterial viability. M. leprae also activated lower levels of TNF-alpha secretion and TNF-alpha mRNA expression than BCG. Mycobacterium-induced activation of apoptotic gene expression was determined over a time course of infection. M. leprae reduced Bad and Bak mRNA expression by 18 h post-stimulation, with a further decrease at 48 h. Outcome of cell viability is determined by the ratio between pro- and anti-apoptotic proteins present in the cell. M. leprae infection resulted in downregulation of gene expression ratios, Bad/Bcl-2 mRNA by 39% and Bak/Bcl-2 mRNA by 23%. In contrast, live BCG increased Bad/Bcl-2 mRNA (29 %) but had a negligible effect on Bak/Bcl-2 mRNA. Heat killed BCG induced only a negligible (1–4 %) change in mRNA expression of either Bak/Bcl-2 or Bad/Bcl-2. Additionally, M. leprae upregulated the expression of anti-apoptotic gene Mcl-1 while, BCG downregulated Mcl-1 mRNA. CONCLUSION: This study proposes an association between mycobacterium-induced apoptosis in THP-1 cells and the regulation of Bcl-2 family of proteins. M. leprae restricts apoptosis in THP-1 cells by downregulation of Bad and Bak and upregulation of Mcl-1 mRNA expression

Evaluation of the Relationship of Low Back Pain with Spinal Anesthesia and its Related Factors in Patients Undergoing Urological Surgery

Background: Spinal anesthesia is the common method in outpatient surgeries, which has complications such as back pain. We aimed to evaluate the relationship between low back pain (LBP) with spinal anesthesia and its related factors in patients undergoing urological surgery. Materials and methods: In this cross-sectional study, 1000 patients undergoing urological surgery were enrolled. The severity of LBP was measured using the VAS (visual analog scale) pain on the 1st day, the 1st week, and the 1st month postoperatively. Patients’ age, sex, and the duration of surgery were collected. data analysis was performed using SPSS software, version 17. Results: Of the 1000 patients undergoing urological surgery, 636 (63.6%) patients and 364 (36.5%) patients underwent spinal and general anesthesia, respectively. In patients under general anesthesia, the LBP prevalence was higher than in patients under spinal anesthesia on the 1st week and the 1st month after surgery (P<0.05). So, the LBP prevalence was as follows: on the 1st day (general anesthesia: 14.5% vs spinal anesthesia: 24.1%, p=0.09), at the 1st week (general anesthesia: 24.9% vs spinal anesthesia:13.5%, P=0.001) and the1th month (general anesthesia: 13.8% vs spinal anesthesia: 4%, P=0.001). On 1st day and 1st week after surgery, the rate of LBP was significantly higher in the >45-year age group than in the age group less than 45 years (P<0.05). The pain rate was higher in patients who had surgery duration of more than 2.5 hours in all three time periods (P=0.001). Conclusion: Although the LBP prevalence on 1st day after surgery in patients undergoing urological surgeries under spinal anesthesia was higher than in patients who underwent general anesthesia, there was a significant decrease in pain levels during the first week and month following the surgery in patients under spinal anesthesia. Older age and longer duration of surgery were related factors to pain

Evaluating the prevalence of nephrolithiasis in kidney transplant recipients admitted to Imam Khomeini Hospital in Urmia in 2018-2019.

Introduction: Nephrolithiasis is almost common urological disease in the world that involves near 10 percent of adult population. Several researches are demonstrative of increasing prevalence and incidence of nephrolithiasis in industrial societies, because of changing the life style, food regimen and obesity that is very common. Though prevalence of nephrolithiasis in grafted kidney is rare, but because of importance of effects after grafting or graft rejection is needed to attention and study. Methods: In this research incidence of nephrolithiasis and the difference of it before and after the kidney transplantation in graft receiver of kidney in Urmia Imam Khomeini hospital for two years in 2018-2019 has studied, and followed after one year. Relation between age, education level, and sex have been evaluated too. Results: In this study 32 receiver of kidney transplant have been studied. Among this 32 patient 3 cases had nephrolithiasis after transplantation that they didn’t have any history of nephrolithiasis, And 3 cases had history of nephrolithiasis that after transplantation no kidney stone was seen (P<0.05).Higher prevalence of nephrolithiasis was significantly related to higher level of education (p<0.05), but age and sex was not significantly different in two groups (P>0.05). Conclusion: It’s concluded that the main reason of nephrolithiasis is the kidney organ that can make stone in the new body, and level of education was higher in the nephrolithiasis group (affected or have the history) than the healthy group

Evaluation of men’s knowledge, attitudes, and performance toward Prostate Cancer in the Urology Clinic of Imam Khomeini Hospital, Urmia, Iran

Introduction: Prostate cancer is the second most common cancer after lung cancer worldwide. In 2018, there were 1276106 new cases and 3.8% (358989 cases) of the population who died of this cancer were men. (What do you mean? All were men because we are talking about prostate cancer, but do you mean the mortality rate?) We aimed to evaluate men's knowledge, attitudes, and performance toward prostate cancer. Materials and Methods: A descriptive analysis was done on 385 men in the urology clinic of Imam Khomeini Hospital. Men aged at least 40 with no history of prostate cancer were included in this survey. The researchers made a questionnaire including two parts: the first part comprised information about knowledge, attitudes, performance, and the second part consisted of demographics. The men’s function was divided into two groups according to performing the PSA test: the good function group (PSA tests were done) and the weak function group (PSA tests were not done).  Data analyzed were analyzed using SPSS software, version 20. Results: The mean±SD age of the men was 63.9±8.9 years and 56.6% of them were city dwellers. 22.7% had a university degree. Most (38.5%) were Self-employed and most (76.3%) had no family history of prostate cancer. Most participants answered the general questions about prostate cancer, but they did not have suitable and reliable information about related risk factors, diet, and sexual activity. ‌ Conclusion: Considering the positive effect of people's knowledge on their attitude and their attitude on their performance, by holding training classes and education for people at risk their attitude and ultimately their performance towards prostate cancer prevention would be improved

On Power Control of Grid-Forming Converters: Modeling, Controllability, and Full-State Feedback Design

The popular single-input single-output control structures and classic design methods (e.g., root locus analysis) for the power control of grid-forming converters have limitations in applying to different line characteristics and providing favorable performance. This paper studies the grid-forming converter power loops from the perspective of multi-input multi-output systems. First, the error dynamics associated with power control loops (error-based state-space model) are derived while taking into account the natural dynamical coupling terms of the power converter models. Thereafter, the controllability Gramian of the grid-forming converter power loops is studied. Last, a full-state feedback control design using only the local measurements is applied. By this way, the eigenvalues of the system can be arbitrarily placed in the timescale of power loops based on predefined time-domain specifications. A step-by-step construction and design procedure of the power control of grid-forming converters is also given. The analysis and proposed method are verified by experimental results.Comment: arXiv admin note: text overlap with arXiv:2205.0346

Generalized Multivariable Grid-Forming Control Design for Power Converters

The grid-forming converter is an important unit in the future power system with more inverter-interfaced generators. However, improving its performance is still a key challenge. This paper proposes a generalized architecture of the grid-forming converter from the view of multivariable feedback control. As a result, many of the existing popular control strategies, i.e., droop control, power synchronization control, virtual synchronous generator control, matching control, dispatchable virtual oscillator control, and their improved forms are unified into a multivariable feedback control transfer matrix working on several linear and nonlinear error signals. Meanwhile, unlike the traditional assumptions of decoupling between AC and DC control, active power and reactive power control, the proposed configuration simultaneously takes all of them into consideration, which therefore can provide better performance. As an example, a new multi-input-multi-output-based grid-forming (MIMO-GFM) control is proposed based on the generalized configuration. To cope with the multivariable feedback, an optimal and structured $H_{\infty}$ synthesis is used to design the control parameters. At last, simulation and experimental results show superior performance and robustness of the proposed configuration and control

Beyond low-inertia systems: Massive integration of grid-forming power converters in transmission grids

As renewable sources increasingly replace existing conventional generation, the dynamics of the grid drastically changes, posing new challenges for transmission system operations, but also arising new opportunities as converter-based generation is highly controllable in faster timescales. This paper investigates grid stability under the massive integration of grid-forming converters. We utilize detailed converter and synchronous machine models and describe frequency behavior under different penetration levels. First, we show that the transition from 0% to 100% can be achieved from a frequency stability point of view. This is achieved by re-tuning power system stabilizers at high penetration values. Second, we explore the evolution of the nadir and RoCoF for each generator as a function of the amount of inverter-based generation in the grid. This work sheds some light on two major challenges in low and no-inertia systems: defining novel performance metrics that better characterize grid behaviour, and adapting present paradigms in PSS design.Comment: 5 pages, 7 figure