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

A prospective study correlating fluid balance and outcome in critically ill patients

Background: Fluid administration can be lifesaving as fluid accumulation after initial resuscitation and stabilization of hemodynamics can lead to avoidable adverse effects and less favorable outcomes.Objective: The aim of the work was to evaluate whether even fluid balance in comparison to negative or even fluid status is correlated with increased morbidity and mortality rates in critically ill patients.Patients and Methods: An observational prospective study was done on 145 patients older than eighteen years, admitted to the general intensive care (Medical & Surgical ICU) units in Helwan University Hospitals and Ain Shams University Hospitals during the period from November 2020 till May 2021.Results: One hundred twenty-four patients (85.5%) who survived, having the median cumulative fluid balance of -110ml (IQR-2.1 – 2.2L) after four days following randomization while the median cumulative fluid balance of the 21 patients (14.5%) who didn’t survive was 3800 ml (IQR 1.7-5.2L), after four days of ICU admission. Fluid balance more than 1.2 liters per day in our study had higher ICU complications: Increased risk of AKI, longer ICU and hospital stays, mechanical ventilation and fluid balance was an independent factor associated with increased mortality.Conclusion: It could be concluded that negative fluid balance for 4 days in critically ill patients was associated with less length of stay in the general ICU, and less mechanical ventilation duration, while positive fluid balance, leads to higher mechanical ventilation duration, vasopressors requirements, and significantly associated with higher mortality

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

Studies on the Recovery of Cu (II) and U (VI) on Highly Adsorptive Modified Magnetic Amine Resins from Dolostone Leachate Solution

Magnetic chelating resin containing amine moiety was obtained by polymerization of chloromethyl styrene with both 5 % and 10% divinylbenzene as a crosslinking agent in the presence of Fe3O4 as magnetite particles, the yield was treated with malononitrile followed by reaction with hydrazine hydrate in the presence of absolute ethanol to get hydrazenyl amine polymer. The obtained resins were investigated by FT-IR, elemental analysis and SEM. The use of magnetite particles was used for increasing the surface of chelating active sites and easy collection from solution. The obtained resins were evaluated toward the uptake of Cu (II) and U (VI) from their aqueous synthetic solutions followed by application on acid leachate of dolostone ore materials from southwestern Sinai. Contact time, pH and initial concentration of the metal ions were investigated as factors affecting the uptake behavior. The modified resins display higher uptake capacity compared to the metal oxide-free resin also high regenerated efficiency

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression.

BACKGROUND: The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. METHODS: We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of between-study heterogeneity were determined using meta-regression. FINDINGS: We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3·0% (95% CI 2·3-3·8) in general populations, 2·8% (1·0-5·2) in intermediate-risk populations, 13·2% (7·2-20·7) in female sex workers, 11·3% (9·0-13·7) in infertility clinic attendees, 12·4% (7·9-17·7) in women with miscarriage, 12·4% (9·4-15·7) in symptomatic women, and 17·4% (12·5-22·8) in symptomatic men. Pooled prevalence of current rectal infection was 7·7% (4·2-12·0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29·0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. INTERPRETATION: C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region. FUNDING: National Priorities Research Program from the Qatar National Research Fund (a member of Qatar Foundation)

Homocysteine and vitamin B 12 status and iron deficiency anemia in female university students from Gaza Strip, Palestine

OBJECTIVE: Nutritional deficiencies are very significant to the overall health of humans at all ages and for both genders, yet in infants, children and women of childbearing age these deficiencies can seriously affect growth and development. The present work is aimed to assess homocysteine and vitamin B12 status in females with iron deficiency anemia from the Gaza Strip.METHODS: Venous blood samples were randomly collected from 240 female university students (18-22 years old) and parameters of the complete blood count, serum ferritin, homocysteine and vitamin B12 were measured. Statistical analysis included the t-test and analysis of variance (ANOVA) using the IBM SPSS software (version 18). Statistical significance was set for p-values <0.05.RESULTS: The results revealed that 20.4% of the students have iron deficiency anemia. The mean serum vitamin B12 level in females with iron deficiency anemia (212.9 ± 62.8 pg/mL) was significantly lower than in normal controls (286.9 ± 57.1 pg/mL) and subjects with microcytic anemia and normal ferritin (256.7 ± 71.1 pg/mL). Significantly higher serum homocysteine levels were reported in the iron deficiency anemia group (27.0 ± 4.6 µmol/L) compared to normal controls (15.5 ± 2.9 µmol/L) and in subjects with microcytic anemia and normal ferritin (18.1 ± 2.7 µmol/L). Statistically significant negative correlations were reported for serum homocysteine with serum ferritin, vitamin B12, hemoglobin, and hematocrit levels.CONCLUSION: Important associations were found between serum homocysteine and markers of iron deficiency. Monitoring homocysteine levels might be essential to understand the development of different clinical conditions including anemia. It seems necessary to conduct prospective trials to determine whether treating anemia ameliorates homocysteine levels

Stability-indicating methods for the determination of pipazethate HCl in the presence of its alkaline degradation product

Three different accurate, sensitive and reproducible stability-indicating methods for the determination of pipazethate HCl in the presence of its alkaline degradation product are presented. The first method is based on ratio-spectra 1st derivative (RSD1) spectrophotometry of the drug at 305 nm, over a concentration range of 10–70 μg mL−1 with mean percentage recovery of 99.69 ± 1.10. The second method utilises quantitative densitometric evaluation of thin-layer chromatography of pipazethate HCl in the presence of its alkaline degradation product, using methanol: ethyl acetate: ammonia (8:2:0.2, v/v/v) as a mobile phase. Chromatograms are scanned at 251 nm. This method analyses pipazethate HCl in a concentration range of 4–14 μg/spot with mean percentage recovery of 100.19 ± 0.77. The third method is an HPLC method for the simultaneous determination of pipazethate HCl in the presence of its alkaline degradation product. The mobile phase consists of methanol: ammonium sulphate (1%), pH = 5.7, (80:20, v/v). The standard curve of pipazethate HCl shows a good linearity over a concentration range of 5–200 μg mL−1 with mean percentage recovery of 100.67 ± 0.91. These methods were successfully applied to the determination of pipazethate HCl in bulk powder, laboratory-prepared mixtures containing different percentages of the degradation product and pharmaceutical dosage forms. The validity of results was assessed by applying standard addition technique. The results obtained were found to agree statistically with those obtained by a reported method, showing no significant difference with respect to accuracy and precision