Darning Needle Impacted in the Male Urethra

Foreign bodies of varied nature have been introduced into the urethra to achieve sexual stimulation. We report the case of a long (9.5 cm) darning needle impacted in the urethra of a male patient following urethral masturbation. After a failed trial at endoscopic extraction the needle had to be removed via open surgery. Follow-up was uneventful

Serum testosterone levels of HbSS (sickle cell disease) male subjects in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Infertility is a major problem in sickle cell disease patients, especially in males. In addition to low serum testosterone, other abnormalities involving the accessory sex organs, such as the seminal vesicles and the prostate gland, as well as marked decrease in ejaculate volume may be observed in male HbSS patients. Hence, the need to study the role of sex hormones as a cause of infertility in male HbSS patients.</p> <p>Methods</p> <p>An unmatched case-control study was performed using seventy-five consenting subjects from Lagos University Teaching Hospital. These included 47 patients with haemoglobin phenotype SS from the Sickle cell clinic and 28 volunteered medical students and members of staff with haemoglobin phenotype AA. Demographic data were obtained using a self-administered questionnaire. A total of 5 mls of blood was collected from each subject between 9.00 am & 11.am, and assayed for serum testosterone concentration.</p> <p>Results</p> <p>The concentrations of serum testosterone in HbSS patients ranged from 0.2 to 4.3 ng/ml with a mean of 1.28 ± 0.72 ng/ml whilst the values in HbAA controls ranged from 1.2 to 6.9 ng/ml with a mean of 2.63 ± 1.04 ng/ml. Seven (25.0%) of the 28 controls had serum testosterone concentration lower than the quoted reference (normal) range whereas 44 (93.6%) of the 47 HbSS subjects had serum testosterone concentration lower than the reference range.</p> <p>Conclusion</p> <p>Overall, subjects with HbSS have significantly lower mean serum testosterone than HbAA controls.</p

Wellness through a comprehensive Yogic breathing program – A controlled pilot trial

<p>Abstract</p> <p>Background</p> <p>Increasing rates of psychosocial disturbances give rise to increased risks and vulnerability for a wide variety of stress-related chronic pain and other illnesses. Relaxation exercises aim at reducing stress and thereby help prevent these unwanted outcomes. One of the widely used relaxation practices is yoga and yogic breathing exercises. One specific form of these exercises is Sudarshan Kriya and related practices (SK&P) which are understood to have favourable effects on the mind-body system. The goal of this pilot study was to design a protocol that can investigate whether SK&P can lead to increased feeling of wellness in healthy volunteers.</p> <p>Methods</p> <p>Participants were recruited in a small university city in Sweden and were instructed in a 6-day intensive program of SK&P which they practiced daily for six weeks. The control group was instructed to relax in an armchair each day during the same period. Subjects included a total of 103 adults, 55 in the intervention (SK&P) group and 48 in the control group. Various instruments were administered before and after the intervention. Hospital Anxiety Depression Scale measured the degree of anxiety and depression, Life Orientation Test measured dispositional optimism, Stress and Energy Test measured individual's energy and stress experiences. Experienced Deviation from Normal State measured the experience of altered state of consciousness.</p> <p>Results</p> <p>There were no safety issues. Compliance was high (only 1 dropout in the SK&P group, and 5 in the control group). Outcome measures appeared to be appropriate for assessing the differences between the groups. Subjective reports generally correlated with the findings from the instruments. The data suggest that participants in the SK&P group, but not the control group, lowered their degree of anxiety, depression and stress, and also increased their degree of optimism (ANOVA; p < 0.001). The participants in the yoga group experienced the practices as a positive event that induced beneficial effects.</p> <p>Conclusion</p> <p>These data indicate that the experimental protocol that is developed here is safe, compliance level is good, and a full scale trial is feasible. The data obtained suggest that adult participants may improve their wellness by learning and applying a program based on yoga and yogic breathing exercises; this can be conclusively assessed in a large-scale trial.</p> <p>Trial Registration</p> <p>Australian Clinical Trial Registry ACTRN012607000175471.</p

Reduced repair of 8-hydroxyguanine in the human breast cancer cell line, HCC1937

BACKGROUND: Breast cancer is the second leading cause of cancer deaths in women in the United States. Although the causes of this disease are incompletely understood, oxidative DNA damage is presumed to play a critical role in breast carcinogenesis. A common oxidatively induced DNA lesion is 8-hydroxyguanine (8-OH-Gua), which has been implicated in carcinogenesis. The aim of this study was to investigate the ability of HCC1937 and MCF-7 breast cancer cell lines to repair 8-OH-Gua relative to a nonmalignant human mammary epithelial cell line, AG11134. METHODS: We used oligonucleotide incision assay to analyze the ability of the two breast cancer cell lines to incise 8-OH-Gua relative to the control cell line. Liquid chromatography/mass spectrometry (LC/MS) was used to measure the levels of 8-OH-Gua as its nucleoside, 8-OH-dG in the cell lines after exposure to H(2)O(2 )followed by 30 min repair period. Protein expression levels were determined by Western blot analysis, while the hOGG1 mRNA levels were analyzed by RT-PCR. Complementation of hOGG1 activity in HCC1937 cells was assessed by addition of the purified protein in the incision assay, and in vivo by transfection of pFlagCMV-4-hOGG1. Clonogenic survival assay was used to determine sensitivity after H(2)O(2)-mediated oxidative stress. RESULTS: We show that the HCC1937 breast cancer cells have diminished ability to incise 8-OH-Gua and they accumulate higher levels of 8-OH-dG in the nuclear genome after H(2)O(2 )treatment despite a 30 min repair period when compared to the nonmalignant mammary cells. The defective incision of 8-OH-Gua was consistent with expression of undetectable amounts of hOGG1 in HCC1937 cells. The reduced incision activity was significantly stimulated by addition of purified hOGG1. Furthermore, transfection of pFlagCMV-4-hOGG1 in HCC1937 cells resulted in enhanced incision of 8-OH-Gua. HCC1937 cells are more sensitive to high levels of H(2)O(2 )and have up-regulated SOD1 and SOD2. CONCLUSION: This study provides evidence for inefficient repair of 8-OH-Gua in HCC1937 breast cancer cell line and directly implicates hOGG1 in this defect

Radiosensitivity in breast cancer assessed by the Comet and micronucleus assays

Spontaneous and radiation-induced genetic instability of peripheral blood mononuclear cells derived from unselected breast cancer (BC) patients (n=50) was examined using the single-cell gel electrophoresis (Comet) assay and a modified G2 micronucleus (MN) test. Cells from apparently healthy donors (n=16) and from cancer patients (n=9) with an adverse early skin reaction to radiotherapy (RT) served as references. Nonirradiated cells from the three tested groups exhibited similar baseline levels of DNA fragmentation assessed by the Comet assay. Likewise, the Comet analysis of in vitro irradiated (5 Gy) cells did not reveal any significant differences among the three groups with respect to the initial and residual DNA fragmentation, as well as the DNA repair kinetics. The G2 MN test showed that cells from cancer patients with an adverse skin reaction to RT displayed increased frequencies of both spontaneous and radiation-induced MN compared to healthy control or the group of unselected BC patients. Two patients from the latter group developed an increased early skin reaction to RT, which was associated with an increased initial DNA fragmentation in vitro only in one of them. Cells from the other BC patient exhibited a striking slope in the dose–response curve detected by the G2 MN test. We also found that previous RT strongly increased both spontaneous and in vitro radiation-induced MN levels, and to a lesser extent, the radiation-induced DNA damage assessed by the Comet assay. These data suggest that clinical radiation may provoke genetic instability and/or induce persistent DNA damage in normal cells of cancer patients, thus leading to increased levels of MN induction and DNA fragmentation after irradiation in vitro. Therefore, care has to be taken when blood samples collected postradiotherapeutically are used to assess the radiosensitivity of cancer patients

Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

Corticosteroids are standard treatment for patients with multiple sclerosis experiencing acute relapse. Because dyspeptic pain is a common side effect of this intervention, patients can be given a histamine receptor-2 antagonist, proton pump inhibitor or antacid to prevent or ameliorate this disturbance. Additionally, patients with multiple sclerosis may be taking these medications independent of corticosteroid treatment. Interventions for gastric disturbances can influence the activation state of the immune system, a principal mediator of pathology in multiple sclerosis. Although histamine release promotes inflammation, activation of the histamine receptor-2 can suppress a proinflammatory immune response, and blocking histamine receptor-2 with an antagonist could shift the balance more towards immune stimulation. Studies utilizing an animal model of multiple sclerosis indicate that histamine receptor-2 antagonists potentially augment disease activity in patients with multiple sclerosis. In contrast, proton pump inhibitors appear to favor immune suppression, but have not been studied in models of multiple sclerosis. Antacids, histamine receptor-2 antagonists and proton pump inhibitors also could alter the intestinal microflora, which may indirectly lead to immune stimulation. Additionally, elevated gastric pH can promote the vitamin B12 deficiency that patients with multiple sclerosis are at risk of developing. Here, we review possible roles of gastric acid inhibitors on immunopathogenic mechanisms associated with multiple sclerosis

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Impact of Yoga on Haemodynamic Function in Healthy Medical Students

Objectives: Yoga improves cardiovascular health in both healthy individuals and those with diagnosed heart disease. This study compares changes in some cardiovascular parameters before and after the practice of Yoga in healthy medical students. Methods: Sixty-four healthy medical students (57 females and 7 males), mean age 21.3 ±2.6 years, attending a Special Study Module ‘Role of Dhyana Yoga in Stress Management’, participated in this study. Systolic (SYS) and Diastolic (DIA) blood pressure, Heart Rate (HR), Stroke Volume (SV), Cardiac output (CO), Total Peripheral Resistance (TPR), Interbeat Interval (IBI), Left Ventricular Ejection Time (LVET), Arterial Compliance (Cwk) and Ascending Aorta Impedance (Zao) were measured before and after six weeks of yogic exercises. Various exercises included asanas (Postures), pranayama (Breathing), and dhyana (Meditation). Data were analyzed using Stata for WindowsTM. Results: Two-tailed paired t-test revealed that practice of yoga caused significant increases in HR (p < 0.05), SV (p < 0.01), CO (p < 0.001) and Cwk (p < 0.01) and decreases in TPR (p < 0.001), IBI (p < 0.05) and Zao (p < 0.001) after practising yoga for 6 weeks as compared to before yoga practice. No significant differences were, however, observed in SYS, DIA, Mean arterial blood pressure (MAP) and LVET. Conclusions: Practice of yoga even for a short period showed ability to improve most of the cardiovascular functions. Regular practice of yoga for a longer period may further improve these functions and possibly result in improved management of their daily stress. Keywords: Healthy adults, haemodynamics, yoga "Impacto del yoga en la función hemodinámica de estudiantes de medicina saludables" RESUMEN Objetivos: El yoga mejora la salud cardiovascular tanto en individuos sanos como aquellos con diagnóstico de enfermedad cardíaca. Este estudio compara cambios en algunos parámetros cardio-vasculares antes y después de la práctica del yoga en estudiantes de medicina saludables. Métodos: Sesenta y cuatro estudiantes de medicina saludables (57 mujeres y 7 hombres), con una edad promedio de 21,3 ± 2.6 años, que asistían a un módulo especial de estudio “Papel de DhyanaYoga en el manejo del estrés”, participaron en este estudio. Antes y después de seis semanas de ejercicios yoga, se midieron la presión arterial sistólica (SIS) y diastólica (DIA), ritmo cardíaco (RC), volumen sistólico de eyección (VS), gasto cardíaco (GC), resistencia periférica total (RPT), tiempo de intervalos interpulsos o interlatidos cardiacos (IBI), tiempo de eyección ventricular izquierda (TEVI), distensibilidad arterial Windkessel (Cwk) y la impedancia de la aorta ascendente (Zao). Los diversos ejercicios incluyeron asanas (posturas), pranayama (respiración) y dhyana (meditación). Se analizaron los datos usando Stata de Windows. Resultados: La prueba T pareado de dos colas, reveló que la práctica del yoga causaba importantes aumentos del RC (p < 0,05), VS (p < 0,01), GC (p < 0,001) y Cwk (p < 0,01) y disminuciones de RTP (p < 0,001), IBI (p < 0,05) y Zao (p < 0,001), tras la práctica de yoga durante seis semanas, en comparación con la situación antes de la práctica de yoga. Sin embargo, no se observaron diferencias significativas en SIS, DIA, MAP y TEVI. Conclusiones: La práctica del yoga incluso durante un corto período mostró capacidad para mejorar la mayoría de las funciones cardiovasculares. La práctica regular del yoga por un período más largo puede mejorar aún más estas funciones, y posiblemente traer como resultado una mejoría en el manejo del estrés cotidiano. Palabras claves: Adultos sanos, hemodinámica, yog