Geographical differences in semen characteristics of 13 892 infertile men

Objective: To assess the relationship between geographical differences and all semen parameters, across 13,892 infertile men of 84 diverse nationalities, recruited at a specialised tertiary hospital that represents the main healthcare provider in Qatar. Male infertility is an important and global public health problem. Despite this, there is a significant scarcity of epidemiological male infertility and semen analysis research in the Middle East and North Africa (MENA) region, as well as geographical comparisons with other parts of the world. Patients and methods: Retrospective study of semen findings of 13 892 infertile men assessed at the Male Infertility Unit at Hamad Medical Corporation, in Qatar between January 2012 and August 2015. Based on country of origin, patients were categorised into those from the MENA region (n = 8799) and non-MENA patients (n = 5093). The two groups were compared across demographic features and semen characteristics: age, sperm volume, sperm total motility, sperm progressive motility (PMot), abnormal sperm forms (ABF), and sperm DNA fragmentation (SDF). Results: The whole sample's mean (SD) age was 35.7 (0.7) years, sperm concentration was 32.3 (0.25) × 106 sperm/mL, total motility was 45.4 (0.2)%, sperm PMot was 25.1 (0.2)%, and ABF was 79.9 (0.2)%. Overall, 841 patients had azoospermia (6.05%), 3231 had oligospermia (23.3%), 4239 had asthenospermia (30.5%) and 6772 had teratospermia (48.7%). SDF (1050 patients) was abnormal in 333 patients (31.7%). MENA patients were significantly younger than their non-MENA counterparts and had a greater semen volume. Non-MENA patients had significantly higher sperm counts, total motility and PMot, and lower ABF. SDF showed no statistical difference between the two groups. MENA patients had significantly higher prevalence of oligospermia, asthenospermia, and teratospermia; and lower prevalence of normal sperm concentration, normal motility, and normal morphology. Throughout the 4 years of the study, MENA patients constantly had significantly lower sperm counts; generally lower sperm total motility percentage and generally lower quality sperm morphology. We compared patients by age (≤40 and >40 years): in the patients aged ≤40 years, the same results as for the overall study were reproduced; in the >40-years group, the same results were reproduced with the exception of morphology, which was not significantly different between the MENA and non-MENA patients. Conclusion: Semen quality is generally lower in male infertility patients from the MENA region compared to non-MENA regions. © 2018 Arab Association of UrologyScopu

Oxidation–reduction potential and sperm DNA fragmentation, and their associations with sperm morphological anomalies amongst fertile and infertile men

Objective: To assess seminal oxidation–reduction potential (ORP) and sperm DNA fragmentation (SDF) in male infertility and their relationships with sperm morphology in fertile and infertile men. Patients and methods: Prospective case-control study comparing the findings of infertile men (n = 1168) to those of men with confirmed fertility (n = 100) regarding demographics and semen characteristics (conventional and advanced semen tests). Spearman rank correlation assessed the correlation between ORP, SDF, and different morphological indices. Means of ORP and SDF were assessed in variable levels of normal sperm morphology amongst all participants. Results: Infertile patients had a significantly lower mean sperm count (32.7 vs 58.7 × 10 6 sperm/mL), total motility (50.1% vs 60.4%), and normal morphology (5.7% vs 9.9%). Conversely, infertile patients had significantly higher mean head defects (54% vs 48%), and higher ORP and SDF values than fertile controls. ORP and SDF showed significant positive correlations and significant negative correlations with sperm head defects and normal morphology in infertile patients, respectively. ORP and SDF were significantly inversely associated with the level of normal sperm morphology. Using receiver operating characteristic curve analysis, ORP and SDF threshold values of 1.73 mV/10 6 sperm/mL and 25.5%, respectively, were associated with 76% and 56% sensitivity and 72% and 72.2% specificity, respectively, in differentiating <4% from ≥4% normal morphology. Conclusion: A direct inverse relationship exists between seminal ORP and SDF with various levels of normal sperm morphology. Using ORP and SDF measures in conjunction with standard semen morphology analysis could validate the result of the fertility status of patients. © 2017 Arab Association of UrologyScopu

Memokath for treating ureteric stricture post cryoablation of renal mass: a case report of rare complication and proposed alternative management

The use of cryoablation in the management of small renal masses is widely acceptable. Although rare but ureteral injury during the procedure with subsequent stricture formation can result in devastating effects on renal function. On the other hand, the management of such strictures requires reconstructive surgery as gold standard. Unfortunately, in some cases the reconstructive surgery might not be feasible, and the treatment usually is ureteral stent insertion that need to be changed regularly. Here we present a case of a 53-year-old gentleman who developed an upper ureteric iatrogenic stricture post cryoablation in which the reconstructive surgery was not feasible due to high procedural risk. We used metallic ureteral stent (Memokath) instead of regular ureteral double J stent. We found that if the reconstructive surgery is not possible the usage of Memokath in treating iatrogenic ureteral strictures is associated with better quality of life, lower costs and a similar functional outcome when compared to ureteral double J stent that needs regular frequent changes

The role of Rezum in the management of refractory urinary retention due to benign prostate hyperplasia: A literature review

Background: Benign prostatic hyperplasia is the most common cause of urinary retention in men (BPH). The gold standard surgical treatment is transurethral resection of the prostate (TURP). However, due to the morbidity and mortality associated with TURP, more minimally invasive treatments, such as vaporizing the prostate with the Rezum system, have been introduced. We investigated the efficacy of Rezum in the treatment of refractory urinary retention due to BPH in this review. Methodology and materials: To conduct this review, the Cochrane methodology for systematic reviews was used. All studies that used Rezum to treat catheter-dependent patients with enlarged prostates were included. The literature search showed 111 studies, 84 of which were excluded due to non-relevance based on titles and 18 due to lack of relevance based on abstract review. Full manuscripts were reviewed in nine studies, three of which were excluded because they did not meet the inclusion criteria. Results: This review included 301 patients in total. The rate of a successful trial of voiding post Rezum therapy was 85%. The complication rated between 3.8 and 4.3% all of which were mild and self-limited. As there was no major complication of Rezum (clavien dindo >2), the procedure-related morbidity is negligible. Conclusion: In this review, Rezum was found to be an efficacious and safe alternative in the treatment of refractory retention with mild complications and minimal morbidity.The author(s) reported there is no funding associated with the work featured in this article. We would like to thank The Arab Urology Association for providing Open Access funding for this article.Scopu

RUINAS DE LA IGLESIA DE SAN PEDRO [Material gráfico]

EN LA ACTUALIDAD ESTÁ RESTAURADA. ADQUIRIDA POR EL COLECCIONISTA EN LAS PALMAS G.C.FOTO DE ARCO DE PIEDRA EN PATIO INTERIOR ABANDONADO. RUINAS DE LA IGLESIA DE SAN PEDRO EN TELDE.Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte. Subdirección General de Coordinación Bibliotecaria, 201

The transformation of Qatar economy into industrialisation era

This study reports the results of a survey distributed to business professionals, educators and students at the State of Qatar. The most important industry in Qatar, according to our respondents, is oil and gas, followed by banking, followed by manufacturing. The least important industries were insurance, services and education. This is a major concern, as industrialisation requires investment in education. The most important skills/competencies needed to promote manufacturing sector in Qatar were communication skills, technology/computer usage, professional knowledge, interpersonal skills, professional integrity/ethics and problem solving.economic trends; emerging economies; industrialisation; Qatar economy; transformation economies.

The transformation of Qatar economy into industrialisation era

This study reports the results of a survey distributed to business professionals, educators and students at the State of Qatar. The most important industry in Qatar, according to our respondents, is oil and gas, followed by banking, followed by manufacturing. The least important industries were insurance, services and education. This is a major concern, as industrialisation requires investment in education. The most important skills/competencies needed to promote manufacturing sector in Qatar were communication skills, technology/computer usage, professional knowledge, interpersonal skills, professional integrity/ethics and problem solving. Copyright © 2011 Inderscience Enterprises Ltd

Design of a low voltage DC grid interfacing PV and energy storage systems

A design of a Photovoltaic (PV) power system architecture with energy storage system for low voltage DC grid applications is presented in this paper. The system components include the following: PV panels with non-isolated dc-dc interleaved boost converters, batteries with non-isolated bidirectional buck converters. The PV converter is controlled using perturb & observe for maximum power point tracking. The batteries' converter is controlled to regulate the DC bus voltage. These parts are linked together with the utility grid through a 600V DC bus. An energy management system is used to control the power flow between the system components. As an example for the low voltage DC grid system integration; a total number of 1,008 panels can be installed on the rooftop of a selected building, with a total power of 320kWp. Different scenarios are considered for the connections of both PV and batteries. A scaled-down experimental prototype, for the PV system with an energy storage system, is used to validate the presented concept. 1 2017 IEEE.ACKNOWLEDGMENT This publication was made possible by NPRP grant # [9-092-2-045] from the Qatar National Research Fund (a member of Qatar Foundation). The findings achieved herein are solely the responsibility of the author[s].Scopu

End-user evaluation of software-generated intervention planning environment for transrectal magnetic resonance-guided prostate biopsies

Background: This study presents user evaluation studies to assess the effect of information rendered by an interventional planning software on the operator's ability to plan transrectal magnetic resonance (MR)-guided prostate biopsies using actuated robotic manipulators. Methods: An intervention planning software was developed based on the clinical workflow followed for MR-guided transrectal prostate biopsies. The software was designed to interface with a generic virtual manipulator and simulate an intervention environment using 2D and 3D scenes. User studies were conducted with urologists using the developed software to plan virtual biopsies. Results: User studies demonstrated that urologists with prior experience in using 3D software completed the planning less time. 3D scenes were required to control all degrees-of-freedom of the manipulator, while 2D scenes were sufficient for planar motion of the manipulator. Conclusions: The study provides insights on using 2D versus 3D environment from a urologist's perspective for different operational modes of MR-guided prostate biopsy systems