Comparative study between intracytoplasmic morphologically selected sperm injection versus intracytoplasmic sperm injection in patients with severe male factor infertility and repeated intra cytoplasmic sperm injection failure

Background: The aim and objective of the study was to compare the results of IMSI and ICSI among infertile couples with severe male factor and repeated ICSI failure.Methods: A comparative prospective randomized controlled study was carried out in Agial IVF/ICSI center, Alexandria with sample of one hundred and forty infertile couples with severe male factor and repeated ICSI failure using ICSI or IMSI with controlled ovarian hyper-stimulation. The main outcome measures were the chemical and clinical pregnancy rates.Results: The couples were randomly subdivided equally into two groups: A, B, 70 underwent intra cytoplasmic morphologically selected sperm injection (IMSI) (group A) and 70 underwent intra cytoplasmic sperm injection (ICSI) (group B) treatment. In the IMSI group there were 19 (27.14%) women got pregnant and 51 (72.86%) did not got pregnant, while in the ICSI group, there were 14 (20.0%) got pregnant and 56 (80.0%) did not got pregnant. Using Pearson Chi-Square test there was no significant difference regarding chemical or clinical pregnancy between the two studied groups.Conclusions: The use of IMSI was proved to be of no evident role in improvement of outcome of pregnancy rate in infertile couples with severe male factor and repeated ICSI failure, as analyzed data didn't show any significant difference

Diagnosis of exudative pleural effusion using ultrasound guided versus medical thoracoscopic pleural biopsy

AbstractIntroductionMedical thoracoscopy increases the diagnostic yield in patients with non-diagnosed pleural effusion when thoracocentesis and closed pleural biopsy (CPB) are non-diagnostic. Chest ultrasound (US) is a very useful imaging method for pleural diseases and the technique of ultra sound-guided cutting biopsy with a tru-cut needle has been well described.Aim of the workThe aim of this work was to diagnose exudative pleural effusion using ultrasound guided versus medical thoracoscopic pleural biopsy.Subjects and methodsForty patients with, non-diagnosed exudative pleural effusion admitted to the chest department, Alexandria university hospital, were enrolled after obtaining informed consents. All patients were subjected to; full history taking, thorough clinical examination, laboratory investigations including prothrombin activity and INR, biochemical, pathological and microbiological evaluation of the pleural aspirate and radiological evaluation. Then the patients were divided (randomly) into 2 groups each containing 20 patients. Pleural biopsies were performed using medical rigid thoracoscopy on group 1 and ultrasound guided tru-cut pleural biopsy on group 2.ResultsThe mean age in-group I was 55.0±13.05years and in-group II was 52.60±17.77years. There was no statistically significant difference between the two groups regarding age, sex, smoking, marital status and past medical conditions. There was no statistically significant difference between the two groups regarding radiological findings. There was no statistically significant difference between the two groups regarding the pleural fluid analysis. There was no statistically significant difference between the two groups regarding the gross pleural findings. In group II non- specific pleurisy was found in 5 (25.0%) patients (by thoracoscopy 1 of them was finally diagnosed as metastatic deposits from adenocarcinoma of unknown primary, one was confirmed to be tuberculous pleurisy and the remaining 3 cases were confirmed to be non- specific pleurisy). As regards complications in-group I, local wound infection occurred in 1 (5.0%) patient, and empyema occurred in 1 (5.0%) patient. In-group II, local wound infection occurred in 1 (5.0%) patient, and empyema occurred in 1 (5.0%) patient.ConclusionIt is better to use thoracoscopy in cases of undiagnosed exudative pleural effusion presented with a sufficient amount of pleural fluid to avoid lung injury while inserting the trocar. Whereas, ultrasound guided tru-cut pleural biopsy may be used in cases of undiagnosed exudative pleural effusion presented with thickened pleura but with an insufficient amount of pleural fluid

URINARY MARKERS OF OXIDATIVE DNA DAMAGE IN TYPE 1 DIABETIC CHILDREN: RELATION TO MICROVASCULAR COMPLICATIONS

  Objective: Type 1 diabetes mellitus (T1DM) is a widespread metabolic disease, which frequently carries with it a significant impact on human health. Oxidative damage and tissue inflammation have been claimed to be a typical pathogenic component for the progression of diabetic complications. We aim in this study to explore the relation of urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) (as a marker of nucleic acid oxidation) to microvascular complications in T1DM.Methods: A case–control study, enrolling 45 T1DM children and an equivalent number of healthy subjects, was performed. Full clinical examination and anthropometric measurement were performed to all subjects. Urinary assessment for 8-oxodG and albumin was done in addition to blood sampling for lipid profile and glycated Hb (HbA1c) assay. Complete ocular examination for assessment of diabetic retinopathy (DR) was also done.Results: Levels of urinary 8-oxodG, serum cholesterol, triglycerides, and low-density lipoprotein in cases were significantly higher than non-diabetics; these levels were likewise higher in uncontrolled T1DM patients in comparison with well-controlled T1DM subjects. Urinary 8-oxodG and HbA1c were significantly higher in diabetic patients with albuminuria and DR compared to patients without complications. Significant positive correlation was found between 8-oxodG with HbA1c (r=0.8, p<0.01), diastolic blood pressure (DBP) (r=0.4, p=0.02), and cholesterol (r=0.4, p=0.05).Conclusion: Urinary 8-oxodG was found to be a reliable marker for assessing oxidative DNA damage in T1DM and can be used in the determination of microvascular complications related to diabetes

Vitamin D Status in Neonatal Pulmonary Infections: Relationship to Inflammatory Indicators

AIM: The study aimed to evaluate serum vitamin D concentrations among neonates with pneumonia. METHODS: This case-control study enrolled 33 neonates with pneumonia in addition to 30 healthy controls. CBC, CRP, Serum vitamin D and Pentraxin 3 levels were measured for all participants. RESULTS: There was significant difference between patients and controls regarding Hemoglobin levels, TLC and CRP (p value < 0.01, = 0.002, < 0.01 respectively). Patients with pneumonia showed significant lower levels of Vit. D (9 ± 2.1) compared to controls (14.1 ± 2.8), P value < 0.01. However, patient group had significant higher levels of Pentraxin 3 (29.1 ± 4.8) compared with controls (12.6 ± 3), P value < 0.01. Moreover, mechanically ventilated patients revealed significant lower vit D (7.7 ± 1.8) and higher pentraxin 3 (32.2 ± 2.6) compared to patients on free oxygen (9.1 ± 2.1, 26.4 ± 3.7 respectively), P value = 0.05, 0.02 respectively. Regarding hospital stay, it had significant positive correlation with serum pentraxin 3 (r = 0.6, P value < 0.01) and significant negative correlation with serum vit D (r = -0.4, P value = 0.04). Finally a significant negative correlation between serum levels of vitamin D and Pentraxin 3 was found (r = -0.4, P value = 0.01). CONCLUSION: Lower concentration of serum vitamin D may be significantly associated with neonatal pneumonia. It also can predict the need for mechanical ventilation and duration of hospital stay in neonatal pneumonia. Similarly, higher levels of Pentraxin 3 may be used as an indicator for mechanical ventilation need and a longer hospital stay in neonates with pneumonia

Cardiological assessment of a cohort of Egyptian patients with osteogenesis imperfecta type III

Background: Osteogenesis imperfecta is a genetic disorder of bones, which has different types. Type III is characterized by recurrent fractures, progressive bone deformities. Cardiac manifestation is one of the important extraskeletal manifestations. Aim of the study: To asses the ECHO cardiographic findings in Egyptian osteogenesis imperfecta patients type III (OI III). Patients and methods: This retrospective study included 35 OI III patients. Their age ranged from 2 months to 18 years with a mean of 6.34 ± 4.85. Standard echocardiography was performed, and heart valves were examined. The dimensions of the left ventricle, and ejection fraction were measured. Results: Abnormal ECHO findings were found in 8 patients (22.9%). Atrial septal defect (ASD), and patent ductus arteriosus (PDA) were the commonest cardiac findings with 5.7% each. Trivial tricuspid regurge was found in 9 patients, this was considered normal finding. There was no significant difference in ECHO findings between males and females with OI III. Conclusion and recommendation: The presence of cardiac abnormalities is documented in OI patients whether congenital or valvular, and so ECHO cardiography should be routine in all patients with OI

Spatiotemporal characteristics of gait in partial foot amputation versus peripheral neuropathy

Background: Partial foot amputation (PFA) is defined as a surgical loss of part of either the forefoot or mid-foot. It is usually secondary to physiological foot dysfunctions such as peripheral neuropathy (PN). The effect of amputation on spatiotemporal characteristics of gait in patients with PFA secondary to PN is still not well established yet Purpose: The aim of the study was to evaluate the effect of PFA on characteristics of gait in patients with PFA secondary to PN compared to PN patients without amputation. Methods: Cadence, stance, swing, double limb support, stride time, step length, and stride length were assessed for 53 participants divided into two groups; (A) PFA group: 25 subjects with healed unilateral PFA and (B) PN Groups: 28 subjects with PN with neither ulcer nor amputation. The gait analysis was conducted at a self-selected speed using the STT three-dimensional motion analysis system. Results: The MANOVA main effect revealed no significant difference between the two groups (p = 0.102). The post hoc test revealed no significant difference between the two groups in all spatiotemporal variables (p > 0.05). Conclusion: Both groups walked at a slow cadence, taking short steps with increased percentage of stance and double limb support.&nbsp

Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions

Abstract Background Imaging is a crucial diagnostic tool in focal liver lesions (FLLs) diagnosis. Without the need for an intravenous contrast agent, two such MRI methods that can distinguish between benign and malignant FLLs are diffusion-weighted imaging (DWI) and magnetic resonance elastography (MRE). The purpose of this study was to assess the utility of diffusion-weighted magnetic resonance imaging and magnetic resonance elastography in the identification and differentiation of benign and malignant hepatic focal lesions. Methods This cross-sectional study was carried out on ninety patients (with mean age 52 years) with hepatic focal lesions (29 benign and 61 malignant). Both MRE and DWI were performed on the patients. A modified gradient-echo sequence was used for MRE, and respiratory-triggered fat-suppressed single-shot echoplanar DW imaging (b = 0.800) was used for DWI. Maps of the apparent diffusion coefficient (ADC) and stiffness were produced. Regions of interest were placed over the FLLs on stiffness and ADC maps to get FLL ADC values and mean stiffness. Receiver operating curve (ROC) analysis was used to compare the roles of MRE and DWI in the differentiation of benign and malignant FLL. Results The ADC of FLLs and MRE stiffness exhibited strong negative correlation [(r: −0.559; p  4.23 and ≤ 1.43, respectively; the area under the curve (AUC) values were 0.991 and 0.894, and the sensitivity and specificity results were 96.7%, 93.1%, and 85.2%, 89.7%, respectively. Conclusions MRE was found to be more sensitive method for identifying benign and malignant hepatic focal lesions than DWI

Minimally-invasive correction of ureteropelvic junction obstruction: do retrograde endo-incision techniques still have a role in the era of laparoscopic pyeloplasty?

Background:This study was designed to review the long-term results and complications of the two techniques of retrograde endopyelotomy; ureteroscopic holmium laser endopyelotomy versus Acucise endopyelotomy. The results were then compared with the laparoscopic pyeloplasty results from a recent publication. Patients and methods: The study was conducted retrospectively from January 2004 to July 2007. Seventy-two patients with ureteropelvic junction obstruction (UPJO) underwent retrograde endopyelotomy using either ureteroscopic laser endoincision (42 patients) or fluoroscopic guided hot-wire balloon (Acucise) endoincision (30 patients). Preoperative radiological assessment included intravenous pyelogram (IVP), helical computerized tomography and diuretic renography. The follow-up period ranged from 12 to 42 months. Subjective success was guided by the change in the preoperative flank pain while objective success on radiological evaluation was documented by either nonobstructed curve of diuretic renogram and/or T1/2 less than 10 min. Results: The mean patient age was 42.6±7.5 years for the laser group and 39.2±15.1 years for the Acucise group ( p = 0.24). The operative time was 66.8±22.2 min in the laser group and 59.8±20.3 min in the Acucise group ( p = 0.84). By objective standards (renal scan), a total of 56 (77.8%) cases were successful (nonobstructed curve). This number included 34 cases in the laser group (80.9%) and 22 cases in the Acucise group (73.3%) ( p = 0.2). Overall 16 failure cases were evident clinically within 1 year of the procedure (eight cases in each group). Most of the failure cases (13/16) presented with clinical obstructive symptoms during the early follow-up period (within 3 months postoperatively) and were then confirmed radiologically (six cases in the laser group and seven cases in the Acucise group) while only three patients had failures at 6, 9 and 11 months postoperatively. There was no statistically significant difference as regards intra-operative complications between the two groups ( p = 0.4). Intra-operative bleeding was seen in three cases in the Acucise group while postoperatively it was reported in one case. Conclusion: The retrograde endopyelotomy approach is safe and effective for the treatment of patients with UPJO. Both ureteroscopic laser and the hot-wire balloon (Acucise) techniques have an important role in the management of UPJO, especially in secondary cases, and they provide comparable long-term objective and subjective outcomes. Laparoscopic pyeloplasty provides far better results but with higher costs, and requires well-equipped centers and involves a long learning curve

Effect of wearing surgical mask during controlled aerobic training on functional capacity and perceived stress in inactive men: a randomized trial

Abstract The study aims to assess the impact of wearing a surgical mask during training on inactive men’s functional capacity and perceived stress. Seventy non-smoker males with body mass index of 25–30 kg/m2 and moderate-intensity activity of fewer than 150 min/week were allocated randomly into two equal groups. The surgical mask group performed a controlled endurance exercise while wearing a surgical mask of three protection layers. The mask-less group performed a controlled endurance exercise without wearing any mask. Functional capacity and Perceived Stress were evaluated before and after the intervention. A significant improvement was observed within groups post-intervention in favor of the mask group regarding the Time Up and Go test (P < 0.05), with a 15.1% percentage improvement. Post-intervention, there was a significant change in the perceived stress score for the mask and mask-less groups (P < 0.05). The improvement in PSS was in favor of mask-less group participants as they changed from being categorized as moderate to mild stress on the PSS, with a 27.1% percentage improvement. Exercising while wearing a surgical mask Positive impacts functional capacity and negatively impacts Perceived Stress in inactive adults. An additional study evaluating the physiological effects of masks on continuous exercise is necessary