An update on endometriosis associated subfertility: what does the most recent evidence say?

Endometriosis is a chronic debilitating disease that affects 10% of women in the reproductive age. Women with endometriosis present with pain, subfertility or both. The prevalence of endometriosis in women with subfertility is estimated to be within the range of 40%-50%. This is a review of the evidence published in the literature. The review was conducted via searching the databases of the Cochrane reviews, European Society of Human Reproduction and Embryology (ESHRE), American Society of Obstetrics and Gynaecology (ACOG), National Institute for Clinical Excellence (NICE) and British Medical Journal (BMJ) best practice articles. Management of women with endometriosis and subfertility has been extensively assessed in the literature. Medical management, surgical approaches and a combination of both improve the spontaneous pregnancy rates for this cohort of patients

Chronic myeloid leukaemia manifesting as a gynecological emergency in a young woman

Chronic Myeloid Leukaemia (CML) is a form of blood cancer that is characterized by unregulated growth of Myeloid cells within the bone marrow. Idiopathic Spontaneous Intraperitoneal Haemorrhage (ISIH) is a rare life-threatening presentation. Case report of a young woman who presented to the emergency department with evidence of intra-abdominal bleeding. thought to be of gynaecological origin. No obvious source for the bleeding could be identified intra-operatively. Laboratory investigations showed evidence of Leukaemia which was confirmed on bone marrow biopsy. CML represents 8% of leukaemia in the UK. Despite being a rare presentation, ISIH should be considered as a possible differential diagnosis for those patients when presenting with evidence of acute abdomen

Tunisian Toxoplasma gondii strains genotyping by the use of AK69 marker

<p>Abstract</p> <p>Background</p> <p>Clinical manifestation due to infection by <it>Toxoplasma gondii </it>is closely linked to the infecting strain of the parasite. Several genetic markers are available to determinate its genotype but few of them are able to discriminate between the three predominant lineages, namely types I, II and III. The number of markers decreases when atypical, recombinant/mixed genotypes need to be identified.</p> <p>Findings</p> <p>In our study, the contribution of sequence polymorphisms in the AK69 gene as typing markers for <it>T. gondii </it>was investigated for the first time in an epidemiological study. The coding region of the marker was amplified, sequenced and aligned for different <it>Toxoplasma </it>strains. The identified nucleotide polymorphism at 12 positions was able to highly discriminate between the different congenital toxoplasmosis Tunisian strains. Moreover the high detection sensitivity level of the marker enabled unambiguous identification of mixed/recombinant genotypes directly.</p> <p>Conclusion</p> <p>It can be, thus, very useful for direct typing in areas where such genotypes are frequently encountered, mainly in the African continent.</p

Electrical and electrochemical properties of Li2M(WO4)2 (M = Ni, Co and Cu) compounds

Li2M(WO4)2 (M = Co, Cu or Ni) materials have been synthesized using the solid-state reaction method. X-ray diffraction measurements confirmed the single phase of the synthesized compounds in the triclinic crystal system (space group P̄). The SEM analyses revealed nearly spherical morphology with the particle size in the range of 1–10 μm. The IR spectra confirm the presence of all modes of WO42−. The impedance spectroscopy measurements showed the presence of grain boundaries and allow determination of the conductivity of the synthesized materials at room temperature. As positive electrode materials for lithium ion batteries, Li2M(WO4)2 (M = Co, Cu or Ni) cathode materials deliver initial discharge capacities of 31, 33 and 30 mA h g−1 for cobalt, nickel, and copper, respectively

Logical equivalence of optical symbolic substitution and shadow-casting schemes

The logical equivalence between two powerful optical computing techniques, namely, optical symbolic substitution and optical shadow-casting is investigated. A common basis for both schemes is developed and their roots are traced back to fundamental principles of logic design. Both shadow-casting and symbolic substitution based optical computing operations are shown to be equivalent to logical sum of product operations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29952/1/0000312.pd

The African hind's (Cephalopholis taeniops, serranidae) use of artificial reefs off Sal Island (Cape Verde): a preliminary study based on acoustic telemetry

The African hind Cephalopholis taeniops (Valenciennes, 1828) is one of the most important commercial demersal species caught in the Cape Verde archipelago. The species is closely associated with hard substrate and is one of the main attractions for SCUBA divers. In January 2006 a former Soviet fishing vessel - the Kwarcit - was sunk off Santa Maria Bay (Sal Island). Young C. taeniops are commonly observed in this artificial reef (AR). In order to investigate the species' use of the AR, 4 specimens were captured and surgically implanted underwater with Vemco brand acoustic transmitters. The fish were monitored daily with an active telemetry receiver for one week after release. Simultaneously, an array of 3 passive VR2 / VR2W receivers was set for 63 days, registering data that allowed an analysis of spatial, daily and short term temporal activity patterns. The results showed site fidelity to the AR, with no migrations to the nearby natural reef. The method used allowed to register a consistent higher activity during daytime and a preference for the area opposite the dominant current

Natural History of Cardiac and Respiratory Involvement, Prognosis and Predictive Factors for Long-Term Survival in Adult Patients with Limb Girdle Muscular Dystrophies Type 2C and 2D

International audienceBackgroundType 2C and 2D limb girdle muscular dystrophies (LGMD) are a group of autosomal recessive limb girdle muscular dystrophies manifested by proximal myopathy, impaired respiratory muscle function and cardiomyopathy. The correlation and the prognostic impact of respiratory and heart impairment are poorly described. We aimed to describe the long-term cardiac and respiratory follow-up of these patients and to determine predictive factors of cardio-respiratory events and mortality in LGMD 2C and 2D.MethodsWe reviewed the charts of 34 LGMD patients, followed from 2005 to 2015, to obtain echocardiographic, respiratory function and sleep recording data. We considered respiratory events (acute respiratory failure, pulmonary sepsis, atelectasis or pneumothorax), cardiac events (acute heart failure, significant cardiac arrhythmia or conduction block, ischemic stroke) and mortality as outcomes of interest for the present analysis.ResultsA total of 21 patients had type 2C LGMD and 13 patients had type 2D. Median age was 30 years [IQR 24–38]. At baseline, median pulmonary vital capacity (VC) was 31% of predicted value [20–40]. Median maximal inspiratory pressure (MIP) was 31 cmH2O [IQR 20.25–39.75]. Median maximal expiratory pressure (MEP) was 30 cm H2O [20–36]. Median left ventricular ejection fraction (LVEF) was 55% [45–64] with 38% of patients with LVEF <50%. Over a median follow-up of 6 years, we observed 38% respiratory events, 14% cardiac events and 20% mortality. Among baseline characteristics, LVEF and left ventricular end diastolic diameter (LVEDD) were associated with mortality, whilst respiratory parameters (VC, MIP, MEP) and the need for home mechanical ventilation (HMV) were associated with respiratory events.ConclusionIn our cohort of severely respiratory impaired type 2C and 2D LGMD, respiratory morbidity was high. Cardiac dysfunction was frequent in particular in LGMD 2C and had an impact on long-term mortality

Implementation of an Affordable Method for MPS Diagnosis from Urine Screening to Enzymatic Confirmation: Results of a Pilot Study in Morocco

Background: Rapid and accurate diagnosis of mucopolysaccharidoses (MPS) is still a challenge due to poor access to screening and diagnostic methods and to their extensive clinical heterogeneity. The aim of this work is to perform laboratory biochemical testing for confirming the diagnosis of mucopolysaccharidosis (MPS) for the first time in Morocco. Methods: Over a period of twelve months, 88 patients suspected of having Mucopolysaccharidosis (MPS) were referred to our laboratory. Quantitative and qualitative urine glycosaminoglycan (GAG) analyses were performed, and enzyme activity was assayed on dried blood spots (DBS) using fluorogenic substrates. Enzyme activity was measured as normal, low, or undetectable. Results: Of the 88 patients studied, 26 were confirmed to have MPS; 19 MPS I (Hurler syndrome; OMIM #607014/Hurler-Scheie syndrome; OMIM #607015), 2 MPS II (Hunter syndrome; OMIM #309900), 2 MPS IIIA (Sanfilippo syndrome; OMIM #252900), 1 MPS IIIB (Sanfilippo syndrome; OMIM #252920) and 2 MPS VI (Maroteaux-Lamy syndrome; OMIM #253200). Parental consanguinity was present in 80.76% of cases. Qualitative urinary glycosaminoglycan (uGAGs) assays showed abnormal profiles in 31 cases, and further quantitative urinary GAG evaluation and Thin Layer Chromatography (TLC) provided important additional information about the likely MPS diagnosis. The final diagnosis was confirmed by specific enzyme activity analysis in the DBS samples. Conclusions: The present study shows that the adoption of combined urinary substrate analysis and enzyme assays using dried blood spots can facilitate such diagnosis, offer an important tool for an appropriate supporting care, and a specific therapy, when available

Toxoplasma gondii infection and toxoplasmosis in North Africa: a review

Toxoplasmosis is an important zoonosis caused by an obligate intracellular parasitic protozoan, Toxoplasma gondii. The disease is distributed worldwide and can affect all warm-blooded vertebrates, including humans. The present review aimed to collect, compile and summarize the data on the prevalence of T. gondii infection in humans and animals in the five North African countries (Morocco, Algeria, Tunisia, Libya and Egypt). Published data from national and international databases were used. Distribution patterns and risk factors for T. gondii infection are discussed, focusing on biotic and abiotic factors. This review is a comprehensive epidemiological analysis of T. gondii infection in North Africa and will therefore be a useful tool for researchers. It can also be used to propose or enhance appropriate national toxoplasmosis control programs