Platelet rich plasma following hysteroscopic adhesolysis: a randomized clinical trial

Background: Intrauterine adhesions (IUAs) is an uncommon condition that occurs after endometrial trauma, still it affects many women seeking fertility. Hystroscopic adhesolysis is the standard management procedure for IUAs, yet many concerns arise about the incidence of recurrence. This study evaluates the efficacy of Platelet rich plasma in decreasing adhesion recurrence following hystroscopic adhesolysis of severe intrauterine adhesions.Methods: A prospective randomized clinical trial held in the Endoscopy Unit of Ain Shams University Hospital, Cairo, Egypt. 160 women with grade-III intrauterine adhesions, according to American Fertility Society criteria, were randomized to either receiving 5ml platelet rich plasma injection into the uterine wall in the most affected parts of the endometrium and lining the uterine cavity by 5ml platelet rich plasma gel followed by intrauterine insertion of folley’s catheter balloon left for two weeks (study group), or only insertion of folley’s catheter balloon for two weeks with injection of placebo solution and using placebo gel (control group). Second look office hysteroscopy was performed 3 months post-operative to assess the grade of intrauterine adhesions. The primary outcome was the incidence of recurrence of intrauterine adhesions. Secondary outcomes were the post-operative improvement of menstrual duration and flow, and pregnancy rate within 1 year post-adhesolysis.Results: 70/81(86.4%) patients showed grade-I adhesions, 8/81 (9.9%) grade-II and 3/81 (3.7%) remained grade-III in the study group compared to 42/78 (53.8%) grade-I, 21/78 (26.9%) grade II and 15/78 (19.2%) grade-III in the control group (p<0.001).Conclusions: Platelet rich plasma shows better improvement of adhesion score, menses duration and menses amount following hystroscopic dissection of severe intrauterine adhesions

Computational and experimental elucidation of the boosted stability and antibacterial activity of ZIF-67 upon optimized encapsulation with polyoxometalates

Water microbial purification is one of the hottest topics that threats human morbidity and mortality. It is indispensable to purify water using antimicrobial agents combined with several technologies and systems. Herein, we introduce a class of nanosized metal organic framework; Zeolitic imidazolate framework (ZIF-67) cages encapsulated with polyoxometalates synthesized via facile one-step co-precipitation method. We employed two types of polyoxometalates bioactive agents; phosphotungstic acid (PTA) and phosphomolybdic acid (PMA) that act as novel antibacterial purification agents. Several characterization techniques were utilized to investigate the morphological, structural, chemical, and physical properties such as FESEM, EDS, FTIR, XRD, and N₂ adsorption/desorption isotherms techniques. The antibacterial assessment was evaluated using colony forming unit (CFU) against both Escherichia coli and Staphylococcus aureus as models of Gram-negative and Gram-positive bacteria, respectively. The PTA@ZIF-67 showed higher microbial inhibition against both Gram-positive and Gram-negative bacteria by 98.8% and 84.6%, respectively. Furthermore, computational modeling using density functional theory was conducted to evaluate the antibacterial efficacy of PTA when compared to PMA. The computational and experimental findings demonstrate that the fabricated POM@ZIF-67 materials exhibited outstanding bactericidal effect against both Gram-negative and Gram-positive bacteria and effectively purify contaminated water

Audit of Extracorporeal Shockwave Lithotripsy in 210 Sudanese Patients at Gezera Hospital for Renal Diseases & Surgery (GHRD&S) Sudan

Background: Extracorporeal Shock Wave Lithotripsy (ESWL) was the breakthrough in urolithiasis management in the 20th century. Objectives: to audit the outcome of ESWL and evaluate its cost effectiveness on the treatment of stone disease in Gezira Hospital for Renal Disease and Surgery (GHRD&S), Sudan Methods: This is a prospective study of 210 patients. ESWL was performed with SLX MX STORZ machine. The number of shocks administered, and the degree of energy were supervised with maximum allowance of 2500-3000 shocks and 5-7 energy in kidney and/or 3000-3500 shock 7-8 energy level for ureteral stone with modification when it was indicated Results: Out of 210 patients; 28, 12, 28 and 2 patients had upper, mid, lower ureteric and vesical stones respectively. Where as 140 patients had renal stones. The success rate of fragmentation of the stones with ESWL was 97.1% for the renal, 92 % for the upper and lower ureter and 83.3% for mid ureteric stones. Vesical stones were not amenable for fragmentation in this study. The overall success rate was 95%. The complications were haematuria in one patient, pain and steinstrasse in two patients. There were no cases of post ESWL renal failure, hypertension and/or residual calculi. Conclusion: This modality of treatment was found to be less costly, acceptable with short hospital stay and short work absence. Keywords: Gezera, extracorporeal shockwave lithotripsy Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 11-1

Efficiency Increase and Fuel Save Benefits of Combined Cycle Operation (Garri Power Plant as a Case Study)

Thermal power plants’ overall efficiency increase, and fuel consumption decrease draw worldwide researcher’s attention due to the limited resources and high cost of fossil fuel. Considering Al-Jaily power plant, the so-called Garri power plants 1 and 2 in Sudan as the case study, this paper compares overall plant efficiency and fuel save with the combined cycle and open cycle operation in which both plants could run. Evaluation of plant’s efficiency is based on the first law of thermodynamics. The results reveal advantage of the combined cycle operation mode in terms of efficiency increase, and on the other hand, in terms of fuel consumption decrease with the same amount of energy produced

Biomimetic 3D models for investigating the role of monocytes and macrophages in atherosclerosis

Atherosclerosis, the inflammation of artery walls due to the accumulation of lipids, is the most common underlying cause for cardiovascular diseases. Monocytes and macrophages are major cells that contribute to the initiation and progression of atherosclerotic plaques. During this process, an accumulation of LDL-laden macrophages (foam cells) and an alteration in the extracellular matrix (ECM) organization leads to a local vessel stiffening. Current in vitro models are carried out onto two-dimensional tissue culture plastic and cannot replicate the relevant microenvironments. To bridge the gap between in vitro and in vivo conditions, we utilized three-dimensional (3D) collagen matrices that allowed us to mimic the ECM stiffening during atherosclerosis by increasing collagen density. First, human monocytic THP-1 cells were embedded into 3D collagen matrices reconstituted at low and high density. Cells were subsequently differentiated into uncommitted macrophages (M0) and further activated into pro- (M1) and anti-inflammatory (M2) phenotypes. In order to mimic atherosclerotic conditions, cells were cultured in the presence of oxidized LDL (oxLDL) and analyzed in terms of oxLDL uptake capability and relevant receptors along with their cytokine secretomes. Although oxLDL uptake and larger lipid size could be observed in macrophages in a matrix dependent manner, monocytes showed higher numbers of oxLDL uptake cells. By analyzing major oxLDL uptake receptors, both monocytes and macrophages expressed lectin-like oxidized low-density lipoprotein receptor-1 (LOX1), while enhanced expression of scavenger receptor CD36 could be observed only in M2. Notably, by analyzing the secretome of macrophages exposed to oxLDL, we demonstrated that the cells could, in fact, secrete adipokines and growth factors in distinct patterns. Besides, oxLDL appeared to up-regulate MHCII expression in all cells, while an up-regulation of CD68, a pan-macrophage marker, was found only in monocytes, suggesting a possible differentiation of monocytes into a pro-inflammatory macrophage. Overall, our work demonstrated that collagen density in the plaque could be one of the major factors driving atherosclerotic progression via modulation of monocyte and macrophages behaviors

Impact of Genetic Polymorphism of Myeloid Differentiation Primary Response Gene 88, Enhancer of Zeste Homolog 2, and B-cell Lymphoma 2 like 11 in Patients with Diffuse Large B Cell Lymphoma Treated with Rituximab, Cyclophosphamide, Doxorubicin, Vincristin

BACKGROUND: Despite the growing landscape of genetic drivers in Diffuse Large B-cell Lymphoma, yet their clinical implication is still unclear and R-CHOP regimen remains a “one size fits all” therapy. We aimed in this study to examine the prevalence of EZH2, BCL211 and MYD 88 genetic polymorphisms in DLBCL patients and correlate the results with various clinical and survival outcomes. METHODS: Genotyping of MYD88 (rs387907272 T/C), EZH2 (rs3757441 C/T), and BCL2L11 (rs3789068 A/G) polymorphisms were conducted using real time polymerase chain reaction analysis in a total of 75 DLBCL patients. RESULTS: Most of our cases carried the wild TT genotype of MYD88 gene (64%), the mutant TT genotype of EZH2 gene (52%) and the wild AA genotype of BCL2L11 gene (48%). Regarding cell of origin, Germinal Centre (GC) phenotype was present in 56% of cases while 44% expressed the Post-GC (PGC) phenotype. Poor response outcome to first line R-CHOP was significantly correlated with the mutated CC genotype of MYD 88 (p=0.02), while better response to R-CHOP was significantly associated with younger age &lt;50 years (p &lt;0.0001), good PS (p=0.046), normal LDH level (p=0.003), earlier stage (p &lt;0.0001), good IPI score (p=0.009), absence of extranodal disease (p &lt;0.0001) and absence of bulky disease (p=0.004). The median PFS and the 2 year OS were significantly higher in younger age, earlier stage, good IPI score, absence of extranodal disease, absence of bulky disease and in GC phenotype. CONCLUSIONS: Our results emphasized that the mutated genotype of MYD 88 gene polymorphism is significantly associated with poor response to R-CHOP therapy

Enhancement the removal capacity of heavy metals from aqueous solution using different aquatic organisms

151-162The Eichhornia sp had high ability for bioremoval of Pb and Cd (97.15 and 97.48%) during 15 min with some ultrastructure changes of the leaf such as, ruptured or disappeared plasma membrane, swollen mitochondria and malformation chloroplast and some anatomical studies; thickness of upper epidermis and mesophyll decreased with presences number of raphide crystals in treated leaf but it not found in untreated plants. It was noticed that treated with Pb was more effect on histological leaf than treated with Cd. While, Gelidium pectinatum had highest efficiency for removal of Cd but during 0.5 hr. The bioremoval efficiency of lead by Gelidium pectinatum increased with Epichlorohydrin 1 from 28.84 to 90.18 % during 240 min contact time and from 77.34 in raw (untreated) algae to 99.58% in case of cadmium during the same contact time

Prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients

Vitamin D deficiency is highly prevalent worldwide and certain groups as elderly persons women and institutionalized persons are particularly prone to severe deficiency. Objective: To identify the prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients. Method: A cross sectional study conducted from the first of October 2014 to the end of March, 2016, where 163 elderly diabetic females who attended Ain shams university hospital at that time were included. They underwent careful history taking, body mass index calculation, blood pressure measurement and Serum 25(OH) D measurement, assessment of insulin secretion including fasting serum C-peptide and CPI measurement in addition to assessment of glycemic control by fasting blood sugar estimation. The level of 25 hydroxy vitamin D (25OHD) was measured. Results: The prevalence of vitamin D deficiency (25OHD level &lt;20 ng/mL ) and insufficiency (25OHD concentration of 20–29 ng/mL) among elderly Egyptian diabetic female patients are 71.2% and 28.2% resp. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index. The 3 independent predictor of the presence of vitamin D deficiency were types of diabetic medications, low C-peptide and CPI values and upon logistic regression analysis for these 3 variables, lower CP level was an independent predictor of the presence of vitamin D deficiency. Results showed a weak negative correlation between serum 25(OH)D, systolic BP, BMI and HOMA IR in studied subjects. Conclusion: Prevalence of vitamin D deficiency among elderly Egyptian diabetic female patients is 71.2%. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index

Zinc Oxide Nanoparticles (ZnO-NPs) Suppress Fertility by Activating Autophagy, Apoptosis, and Oxidative Stress in the Developing Oocytes of Female Zebrafish

In vertebrates, the core mechanisms that control gametogenesis are largely multiple, complex, successive, and orchestrated by intrinsic and extrinsic factors. However, age, health status, and hormonal activity are important factors for good fertility; other intangible intracellular molecular mechanisms that manage oocyte development are still unclear. The present study was designed to elucidate the ultrastructure changes in the ovary in response to its exposure to zinc oxide nanoparticles (ZnO-NPs) and to explore the role of autophagy and apoptosis during egg maturation and ovulation on the fertility of female zebrafish. In our study, ZnO-NPs could induce cytotoxicity in the maturing oocyte by activating autophagy and apoptosis in a caspase-dependent manner and could induce oxidative stress by generating reactive oxygen species (ROS) that elevated the mutated ovarian tP53 protein. Simultaneously, necroptosis developed, mimicking the features of apoptosis and necrosis. Collectively, ZnO-NPs created a suitable necrotic environment that led to follicular developmental retardation that altered oocyte ovulation and reduced fecundity of female zebrafish