Hormonal and Histological Aspects of Germ Cell Aplasia among a Group of Infertile Men in Gaza Strip

Background: Germ cell aplasia is a type of azoospermia characterized by hormonal abnormalities as well as histopathological features. Objective: To assess hormonal and histological aspects of germ cell aplasia among infertile men in Gaza Strip. Materials and methods: A total of 375 infertile men visiting the Specialized Medical Centers in Gaza strip were subjected for testicular biopsy. Out of them 74 showed germ cell aplasia. They were interviewed to fill in a questionnaire and blood samples were drawn for determination of testosterone, prolactin, luteinizing hormone (LH) and follicular stimulating hormone (FSH). Forty four fertile men served as controls. Data were computer analyzed using SPSS/ PC, version 18.0. Results: Germ cell aplasia represented 74 (19.7%) among azoospermic men in Gaza Strip as indicated by testicular biopsy. The mean age of patients and controls was 29.9±5.9 and 31.2±5.7 years, respectively. Medical history showed that varicocele and hormonal problems were significantly higher in patients than controls (P=0.042 and P=0.008, respectively). The number of patients who had abnormal levels of testosterone, prolactin, LH and FSH were 44 (59.5%), 36 (48.6%), 57 (77.0%) and 67 (90.5%) compared to controls of 7 (15.9%), 7 (15.9%), 2 (4.5%) and 13 (29.5%), respectively with c2=21.326, P=0.000; c2=12.098, P=0.000; c2=55.122, P=0.000 and c2=47.020, P=0.000, respectively. Testicular biopsy revealed that infertile men with germ cell aplasia showed Sertoli cell only with partial atrophy, Sertoli cell only with Leyding cell hypoplasia and Sertoli cell only with interstitial fibrosis. Conclusions: Hormonal abnormalities and histopathological features were identified in germ cell aplasia

Blood lead level in relation to awareness and self reported symptoms among gasoline station workers in the Gaza strip

Background: Leaded gasoline is being used in Gaza Strip. Measurements of blood lead level (BLL) and relate it to awareness of gasoline station workers would be helpful in lead protection programs. Purpose: To determine BLL and to assess its relation to awareness and self reported symptoms among gasoline station workers in the Gaza Strip. Methods: A cross section of 72 workers was asked to fill in a questionnaire. BLL was determined by atomic absorption spectrometry. Results: Thirty four (47.2%) workers had BLL> 10? g/dl. The mean BLL was inversely related to the education level (p= 0.001). Workers worked d5 years in the station had lower BLL than those worked> 5 years (7.8±5.6 v 12.5±5.8? g/dl, p= 0.004). The variation in workers knowledge by their BLL was not significant. Higher BLL was generally found in workers who did not practice protective measures compared to those who did, with significant difference for respiratory mask (12.4±5.9 v 5.6±1.6? g/dl, p= 0.001), gloves (13.1±6.0 v 8.6±4.9? g/dl, p= 0.001) and frequent milk drink (13.5±6.0 v 9.3±5.2? g/dl, p= 0.018). Higher BLL was also found in workers who reported symptoms than in those who did not, with significant differences for irritability (12.4±5.4 v 9.2±5.6? g/dl, p= 0.031), headache (12.2±5.8 v 9.0±5.9? g/dl, p= 0.046), concentration difficulties (12.9±5.8 v 9.4±5.6? g/dl, p= 0.015), sleep disturbances (14.1±5.8 v 8.9±5.0? g/dl, p= 0.001) and hypertension (13.3±6.4 v 8.1±2.9? g/dl, p= 0.001). Conclusions: High BLL was associated with low education level, long work duration, lack of protective measures and increase self reported symptoms. Educational programs on

Impact of Age on Ovarian Response and IVF Outcome during Controlled Ovarian Hyperstimulation in Women from Gaza Strip

Background: Although age is an important factor in female fertility, not much date were focused on the relationship between age and ovarian response and in vitro fertilization (IVF) outcome. However, the female reproductive capacity varies with age. Objective: To assess the impact of age on ovarian response and IVF outcome during controlled ovarian hyperstimulation in women from Gaza Strip. Methods: This prospective cohort study consisted of 75 women attending IVF at Al-Basma Fertility Center in Gaza City. The number of oocytes and embryos were recorded for each female and the occurrence of pregnancy was followed for three months. The obtained data were computer analyzed using SPSS statistical package version 18. Results: The mean age of the study population was 29.2±5.9 years. The total number of oocytes was significantly decreased with increasing age (F= 3.932 and P= 0.024). In this context Pearson correlation test exhibited negative significant correlation between women age and the number of mature oocyte (r=-0.276, P= 0.017). There was an inverse relationship between age and ovarian response (F= 6.773 and P= 0.001), showing good response (9-16 oocytes) at mean age of 26.7±5.0 years. When related to women age, IVF outcome showed that the chance of getting pregnant increased with decreased age (F= 4.278 and p= 0.018). Conclusion: The ovarian response and the chance of getting pregnancy were diminishing with ageing, implying that maternal age should by consider during IVF program

Homocysteine and hematological indices in hemodialysis patients

Objectives: To explore the relationship between homocysteine and various hematological indices in hemodialysis patients. Patients and Methods: This case-control study comprised 60 hemodialysis patients and 60 healthy controls matched for gender and age. Hemodialysis duration was 3.2±2.9 year at frequency of 2.6±0.6/week. Hypertension and diabetes were the most common self-reported disorders among the hemodialysis patients. Results: Serum homocysteine was significantly higher in hemodialysis patients than in controls (50.8±9.7 vs. 13.1±3.7 μmol/l, P= 0.000). White blood cell (WBC) and platelet (PLT) counts were significantly higher in hemodialysis patients than in controls [(7.18±2.37 x109/L and 266.3±111.9 x109/L vs 5.95±1.37 x109/L and 222.0±54.1 x109/L) with P= 0.017 and P= 0.045, respectively]. In contrast, red blood cell (RBC), hemoglobin, and hematocrit were significantly lower in hemodialysis patients (3.1±0.5 x1012/L, 8.9±1.5 gm/dl and 26.3±4.6%) than in controls (4.0±0.4 x1012/L, 12.8±1.6 gm/dl and 45.0±4.6%) with P= 0.000. Prothrombin time (PT) and international normalized ratio (INR) were significantly higher in hemodialysis patients compared to controls (16±3 sec and 1±0 vs. 14±0 sec and 1.0±0.1, P= 0.000), whereas activated partial thromboplastin time (APTT) was significantly decreased in hemodialysis patients (25±5 vs 33±2 sec, P= 0.000). Homocysteine correlated directly with WBC count (r= 0.338, P= 0.008) and PLT count (r= 0.369, P= 0.000) whereas inverse correlations were found between homocysteine and RBC count (r=-0.648, P= 0.000), hemoglobin (r=-0.733, P= 0.000) and hematocrit (r=-0.836

Intraosseous Lipoma of Calcaneus as a Rare Cause of Heel Pain

Bone lipoma is a rare, primary and benign tumor. In recent years, its detection rate is higher as a result of the increasing use of accurate and more detailed cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) plus the utilization of advanced histological diagnostic facilities. The radiographic appearance on x-ray is not usually characteristic of this lesion and therefore requires differential diagnostics conducted for a long time. However, CT and MRI allow for a tissue-specific diagnosis. The microscopic features are usually those of mature adipose tissue. Sometimes, still, pathological reports may show discordance with radiologic findings. For optimal management, surgical curettage and packing with autogenous bone grafts is usually recommended if the lesion is causing the pain or if the correct diagnosis cannot otherwise be obtained. Our case is a 43-year-old female patient who presented to our clinic with chronic left foot pain. Pain was localized over the left heel with radiation to surrounding areas. The radiological diagnosis of intraosseous lipoma was made based on CT imaging and confirmed later through biopsy. Surgical intervention was needed after failure of conservative management. Curettage of all lesion and packing with autogenous bone grafts was done. Postoperatively, the patient showed remarkable improvement and follow up consultations showed good healing and no signs of recurrence

Testosterone and gonadotropins in infertile men with Sertoli cell only syndrome from Gaza strip

Aim: To assess serum testosterone and gonadotropins in Sertoli cell only syndrome patients from Gaza Strip. Methods: Based on testicular biopsy, a cross section of 74 Sertoli cell only syndrome patients were enrolled in the study. Age matched 44 fertile men were served as controls. Patients and controls were questioned for their medical history. Blood samples were drawn and serum testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) were determined by enzyme-linked immunosorbent assay. Data were computer analyzed using SPSS/PC, version 18.0. Results: Varicocele and hormonal problems were significantly more frequent among patients than controls (P< 0.05). Serum testosterone was significantly lower in patients compared to controls (1.7±1.3 versus 5.0±2.2 ng/ml, P= 0.000). In contrast, LH and FSH were significantly higher in patients than controls (12.8±9.7 and 20.8±14.8 mlU/ml versus 6.3±3.1 and 7.7±3.9 mlU/ml, P= 0.000, respectively). Hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed lower levels of testosterone compared to the normal reference value (0.9±0.5 and 0.5±0.4 ng/ml versus 2.0-7.0 ng/ml). Higher levels of LH and FSH were recorded in hypergonadotrophic hypogonadism (24.5±2.6 and 37.4±6.7 mlU/ml) compared to the reference values of 2.0-13.0 and 2.5-10.0 mlU/ml, respectively whereas LH and FSH levels were lower in hypogonadotrophic hypogonadism (0.6±0.4 and 0.6±0.5 mlU/ml, respectively). In this context, all hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed abnormal levels of testosterone, LH

Risk factors associated with nutritional rickets among children aged 2 to 36 months old in the Gaza Strip: a case control study

This study assessed the various risk factors associated with nutritional rickets among children aged 2–36 months old in the Gaza Strip. The study sample consisted of 170 children with rickets and 170 control children. A questionnaire interview was used. Descriptive statistics, Chi-square, odd ratios and logistic regression were applied. Rickets was higher among children of unemployed mothers. Rickets was also higher among exclusively breast-fed children (OR= 2.3, P= 0.000). Early introduction of complementary food particularly that contains eggs or fishes protects against rickets. Children who were not exposed to sunlight had more rickets (OR= 16.3, P= 0.000). Rickets was higher with decreasing frequency of exposure to sunlight and among children who had been fully dressed. None of the control children were found to live in the basement compared to 11.8% cases. The more deliveries the mothers had, the more rickets was found among their children (P= 0.028). Rickets was higher among children of mothers who did not receive health education (OR= 41.3, P= 0.000). In conclusion, lack of sunlight exposure and health education, and exclusive breastfeeding were the major risk factors contributed to rickets among children in the Gaza Strip

Trichonamas vaginalis infection among Palestinian Women: Prevalence and Trends during 2000-2006

Aim: Trichomonas vaginalis has not been studied in Gaza and there is no available data on the prevalence of this sexually transmitted disease (STD). The objectives of this study were to determine the prevalence of Trichomonas vaginalis (T. vaginalis) among Palestinian women attending a child and mother care center in Gaza, Palestine and to estimate the trend of prevalence over the period from 2000-2006. Materials and Methods: A cross-sectional descriptive study was conducted among 430 pregnant women attending a child and mother care center in Gaza. The clinical and gynecologic examinations were performed according to the complaints reported by each woman, especially infertility. Vaginal and cervical swabs were collected and stained with Papanicolaou (Pap) stain. Results: Out of 423 women, a total of 77 were found to be infected with T. vaginalis, for a prevalence of 18.2%. A decrease in the prevalence of T. vaginalis was observed with increasing age. A significant association between vaginal discharge and T. vaginalis infection was found (P= 0.001). No clear trend was noted in the prevalence of T. vaginalis over the period from 2000-2006. Conclusions: A considerable prevalence of T. vaginalis was found among pregnant women in Gaza. These results may be useful for health authorities, especially for antenatal care and protection against STDs