Can Vitamin D Supplemental Therapy improve the Disturbed Follicular Fluid Milieu and affect the Outcome of ICSI?

Background: Vitamin D (VD) receptor is widely distributed in reproductive systems thus hypovitaminosis D can impair the response to ovarian stimulation. Objectives: Determination of the effect of VD supplemental therapy (VD-ST) on the ovarian follicular fluid (FF) milieu in infertile women undergoing intracytoplasmic sperm injection (ICSI). Patients and Methods: 103 infertile women were evaluated clinically and gave blood samples for estimation of serum and FF levels of 25-hydroxy vitamin D (25-OH-VD), and FF levels of tumor necrosis factor-α (TNF-α) and total antioxidant capacity and underwent a cycle of ICSI using the antagonist protocol before and after receiving 3-month VD-ST. The study outcome is the impact of VD-ST on the clinical pregnancy rate. Results: Serum (P=0.0004) and FF (P=0.040) levels of 25-OH-VD were significantly increased, while FF levels of TNF-α were significantly (P95% fragmentation (P=0.019) rates were significantly increased with doubling of number of high-grade embryos and clinical pregnancy rate. These changes were correlated positively with increased in serum and FF levels of 25OH-VD and decrease of TNF-α level. Statistical analyses defined the higher increase in serum and FF levels of 25OH-VD as the important predictors for the number of oocytes and clinical pregnancy, while the higher decrease in FF levels of TNF-α was the important predictor for the rate of high-grade embryos. Conclusion: VD-ST may play an important role for success of ICSI through increasing serum and FF levels of VD and decreasing FF levels of TNF-α

The Association Between FokI Vitamin D Receptor Polymorphisms With Metabolic Syndrome Among Pregnant Arab Women

Metabolic syndrome (MetS) is a serious health condition that is becoming extremely threatening in Saudi Arabia. The link between vitamin D receptor (VDR) gene polymorphisms and maternal MetS has been observed in several ethnic groups, but is yet to be clarified in the Arabian population. This study aims to investigate the relationship between the FokI VDR genotype and the risk of MetS and its components in pregnant Saudi women. A cross-sectional study was conducted using 368 pregnant Saudi women on first trimester screened for MetS (44 with MetS and 324 without MetS). Measurements included anthropometrics, glycemic and lipid profile and 25(OH)D. TaqMan genotyping assay was used to determine Fokl VDR genotype of participants. Vitamin D deficiency (25(OH)D <50nmol/l) was seen in 85% of the participants. An estimated 12% of participants had MetS. In the MetS group, the FokI VDR genotyping frequencies for FF, Ff, and ff genotypes were 50%, 36.4% and 13.6%, respectively. In controls, the frequencies were 62.7%, 31.4% and 5.9%, respectively. No significant association between the individual MetS components and FokI VDR genotypes were observed. Nevertheless, carriers of the ff allele had a significant risk for full maternal MetS [Odds Ratio 4.2 (95% Confidence Interval 1.4-12.2; adjusted p=0.009). The study suggests that the ff FokI VDR genotype is a genetic marker of maternal MetS in pregnant Arabian women. Prospective studies that include neonatal outcomes may confirm present findings

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

EFFECT OF LOW ENERGY VERSUS MEDIUM ENERGY RADIAL SHOCK WAVE THERAPY IN THE TREATMENT OF CHRONIC PLANTER FASCIITIS

Background: Plantar fasciitis (PF) is the most common cause of heel pain and it can often be a challenge for clinicians to treat successfully. Radial shock wave therapy (RSWT) has been introduced recently for treatment of musculoskeletal disorders. Different energy levels of shock wave therapy have been used in the literatures for treatment of PF with no clear settled parameters. Therefore, the purpose of this study was intended to investigate and compare the efficacy of two different energy levels of RSWT on PF patients. Methods: Forty patients having unilateral chronic PF were recruited for the study from orthopedic outpatient clinics of Cairo University hospitals and National Institute of Neuromotor System Cairo Egypt, with a mean age of (47.15±4.57) years. Patients were randomly assigned into two equal groups. Group (A) treated with low intensity level of 1.6 bars (0.16 mJ/mm2) RSWT and group (B) treated with medium intensity level of 4 bars (0.38 mJ/mm2) RSWT. Functional assessment of the foot based on Foot Function Index (FFI) and Present pain intensity was measured during rest by Visual Analogue Scale (VAS). Results: There was as significant decreased in the total FFI scores from (118.42 ±6.51) to (81.37 ±3.46) for group (A) and from (118.93 ±6.85) to (58.50 ±3.22) for group (B). Also regarding VAS Scores there was as significant decreased in the pain intensity from (5.11 ±0.41) to (2.85 ±0.31) for group (A) and from (4.95 ±0.39) to (2.05 ±0.22) for group (B). Conclusion: Radial shock wave therapy is an effective modality that should be considered in the treatment of chronic PF, while the medium energy level RSWT is better than the low energy level RSWT in regarding to the measured treatment outcomes

The Role of Marketing Campaigns in Attracting Teenage Children to Electronic Terrifying Games “Case Study on the Formal Body of the Momo Electronic Game”

With the huge and accelerating technical and electronic progress in this era, methods of play and entertainment have evolved at the present time, and electronic devices and games that have found a popular market for them have emerged, and one of the most common games in this era is what is known as terrifying electronic games, which depend on displaying frightening events on the screen, And enabling the player to control the course of these events in what is known as the interactive relationship, and the Momo game was chosen in the study to apply to it as the terrifying Momo character affected the users and their curiosity through its formality, or through its method to provoke the user and make it meet Perhaps with it, which made the spread of it happen quickly all over the world, and in the midst of this great interest in terrifying electronic games comes the question about the role of electronic marketing campaigns in the spread of such games in spite of the warning about their damages and the dangers that can happen to our children but that The attraction of children to the formal body of its horrific characters or the way to interact and interact with it and their desire to try these games was a reason for that spread to confirm the importance of that study to produce its own results

A study of CD11b rs1143679 gene polymorphism in Egyptian systemic lupus erythematosus patients

Background/aim The exact cause of systemic lupus erythematosus (SLE), an autoimmune disorder, is still vague. However, it is believed that its pathogenesis could be a result of the interplay between genetics and the environment. One such genetic factor is a single-nucleotide polymorphism in the CD11b gene (rs1143679) that has been shown to potentially increase a person’s susceptibility to SLE. This study aims to investigate the possible link of CD11b rs1143679 gene polymorphism to the risk of developing SLE, as well as the different manifestations and the disease severity in the studied group of Egyptian SLE patients. Patients and methods The present study enrolled 50 patients with SLE from Benha University Hospitals, Egypt. In addition to 30 apparently healthy individuals served as control, the CD11b gene (rs1143679) genetic variant was investigated by real-time PCR. The individuals with SLE were based on the Systemic Lupus International Collaborating Clinics criteria. Results A significant association of GA genotype (odds ratio=1.908, 95% confidence interval=1.021–3.568, P<0.05) with the risk to develop SLE and A allele was also linked to an elevated risk for SLE in comparison to the G allele (odds ratio=1.881, 95% confidence interval=1.038–3.408, P<0.05). Conclusion The CD11b rs1143679 gene polymorphism might be a potential risk factor for SLE in Egyptians

Evaluation and Management of Skeletal Health in Celiac Disease: Position Statement

OBJECTIVE: To review the evaluation and management of skeletal health in patients with celiac disease (CD), and to make recommendations on screening, diagnosis, treatment and follow-up of low bone mineral density (BMD) in CD patients