Hijama (wet cupping) for female infertility treatment: a pilot study

Background: To assess the effectiveness of wet cupping (Hijama) as a treatment of female factor infertility. The primary outcome measured was pregnancy rates after Hijama. The secondary outcome measured was the effect on the reproductive hormonal profile before and after Hijama.Methods: A pilot clinical study was conducted for the use of Hijama as treatment for female infertility at King Abdulaziz University Hospital from September 2013 to May 2015. Inclusion criteria included: patients with female factor infertility between 20-50 years of age. Exclusion criteria were women who were menopausal, male factor infertility and pregnancy. Informed consent was obtained from all patients. Upon inclusion in the study, an interview with the participant was done. Blood tests were done at the initial visit which included a complete blood count and hormonal profile (FSH, LH, Estradiol, Progesterone, TSH) if not done already. Patients had repeated Hijama each month if pregnancy did not occur.Results: Out of 59 women, 31 (52.5%) had primary infertility and 28 (47.5%) had secondary infertility. The duration of infertility ranged from 1 to 22 years. In 40 women (67.8%), the partner had a normal semen analysis and 19 (32.2%) had oligospermia. 12 women had an abnormal hystosalpngiogram (20.3%) with two women with complete bilateral tubal blockage. 36 women (61%) had a normal hormonal profile (FSH, LH, TSH, Prolactin). 12 patients (20.3%) became pregnant after hijama; 7 patients had only one or two sessions of Hijama and one patient had 7 sessions. Factors that were found to affect pregnancy rate included: patient with no dysmenorrhea (p 0.034), secondary infertility diagnosis (p 0.005) and history of OCP use (P 0.04). There were significant changes of the hormonal profile before and after Hijama.Conclusions: Hijama might be beneficial in infertile women to achieve a pregnancy. Further studies are needed to confirm the findings from this study

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Description topologique de l'architecture fibreuse et modélisation mécanique du myocarde

My thesis focuses on the geometrical, mechanical and numerical modelling of the human heart. In the geometrical part, we checked a conjecture according to which myocardial fibres run as geodesics on a nested set of surfaces. To this aim, the fibre trajectories and layers of fibres have been identified. In the mechanical modelling, we established a new macroscopic constitutive law for the myocardium by means of discrete homogenization technique from geometrical and mechanical microscopic information on myocardial cells. This constitutive law takes into account the fibrous structure of the muscle. Moreover, we used our method of homogenization in modelling the mechanical behaviour of carbon nanotubes.Dans mon travail de thèse je m'intéresse à la modélisation géométrique, mécanique et numérique du myocarde. La partie géométrique consiste à vérifier une conjecture selon laquelle les fibres myocardiques courent comme des géodésiques sur des surfaces emboîtées. pour cela, les trajectoires et les surfaces de fibres ont été identifiées. Dans la partie mécanique, nous avons établi une nouvelle loi de comportement macroscopique du myocarde par une technique d'homogénéisation discrète à partir de la description microscopique de l'arrangement des cellules cardiaques et de leur comportement mécanique individuel. Cette loi de comportement prend en compte la structure fibreuse. De plus, nous avons applique notre méthode d'homogénéisation aux nanotubes de carbone

Description topologique de l'architecture fibreuse et modélisation mécanique du myocarde

Ce travail de thèse est effectué en collaboration avec l'équipe RFMQ du laboratoire TIMC. Il s'agit d'une modélisation géométrique, mécanique et numérique du myocarde. La partie géométrique consiste à vérifier une conjecture selon laquelle les fibres myocardiques courent comme des géodésiques sur des surfaces emboîtées. Nous avons vérifié sur des données expérimentales cette conjecture sur le ventricule gauche dont les trajectoires et les surfaces des fibres ont été identifiées. Dans la partie mécanique, nous avons construit une loi de comportement macroscopique du myocarde en grandes déformations par une technique d'homogénéisation discrète basée sur la description microscopique de l'arrangement des cellules cardiaques et de leur comportement mécanique individuel. De plus, nous avons appliqué notre méthode d'homogénéisation aux nanotubes de carbone dont, dans le cas des petites déformations, nous avons obtenu l'expression analytique de la loi de comportement.GRENOBLE1-BU Sciences (384212103) / SudocSudocFranceF