Genetic and Morphological Diversity Assessment of Five Kalanchoe Genotypes by SCoT, ISSR and RAPD-PCR Markers

Determining the appropriate parents for breeding programs is the most important decision that plant breeders must make to maximize the genetic variability and produce excellent recombinant genotypes. Several methods are used to identify genotypes with desirable phenotypic features for breeding experiments. In this study, five kalanchoe genotypes were morphologically characterized by assessing plant height, number of inflorescences, number of flowers, flower length, flower diameter and number of petals. The analysis showed the distinction of yellow kalanchoe in the plant height trait, while the orange kalanchoe was distinguished in the number of inflorescences, the number of flowers and flower length traits, whereas the violet kalanchoe possessed the largest flower diameter and the highest number of petals. The molecular profiling was performed by random amplified polymorphism DNA (RAPD), inter-simple sequence repeats (ISSR) and start codon targeted (SCoT)-polymerase chain reaction (PCR) tools. Genomic DNA was extracted from young leaves and the PCR reactions were performed using ten primers for each SCoT, ISSR and RAPD marker. Only four out of ten primers showed amplicon profiles in all PCR markers. A total of 70 bands were generated by SCoT, ISSR and RAPD-PCR with 35 polymorphic bands and 35 monomorphic bands. The total number of bands of RAPD, ISSR and SCoT was 15, 17 and 38, respectively. The polymorphism percentages achieved by RAPD, ISSR and SCoT were 60.25%, 15% and 57%, respectively. The cluster analysis based on morphological data revealed two clusters. Cluster I consisted of violet and orange kalanchoe, and cluster II comprised red, yellow and purple kalanchoe. Whereas the cluster analysis based on molecular data revealed three clusters. Cluster I included only yellow kalanchoe, cluster II comprised orange and violet kalanchoe while cluster III comprised red, and purple kalanchoe. The study concluded that orange, violet and yellow kalanchoe are distinguished parents for breeding economically valued traits in kalanchoe. Also, the study concluded that SCoT and RAPD markers reproduced reliable banding patterns to assess the genetic polymorphism among kalanchoe genotypes that consider the basis stone for genetic improvements in ornamental plants

Artificial intelligence in andrology: From Semen Analysis to Image Diagnostics

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine

[8] Photo-selective vaporisation of the prostate (PVP) with the 180-W GreenLight XPS laser, single-centre experience in high-risk patients

Objective: To evaluate the safety and efficacy of the 180-W GreenLight XPS laser for treating high-risk patients with benign prostatic hyperplasia (BPH) and to assess patient’s satisfaction with treatment. Methods: We retrospectively reviewed the charts of 44 high-risk patients who underwent PVP with the 180-W GreenLight XPS laser performed by a single surgeon between November 2013 and December 2016, with a follow-up of ⩾1 year. High-risk patients were classified as those who had at least one of the following: on anticoagulant therapy, urinary retention, or prostate size of >100 mL. Preoperative, intraoperative, postoperative, and long-term satisfaction were recorded. Results: In all, 44 patients were included in the study. The mean (range) age was 69.9 (55–88) years. All patients had at least one high-risk factor. In all, 30 patients had urinary retention, 12 had ischaemic heart disease on anticoagulant therapy, the mean (range) prostate size was 111.5 (40–250) mL, 20 patients had a prostate size of <100 mL, and the remaining 24 ⩾ 100 mL. There was renal impairment in six patients, bladder stones in two, previous transurethral resection of the prostate in four, haematuria in six, recurrent urinary tract infections (UTIs) in 11, urinary incontinence in six, and 29 patients had other lower urinary tract symptoms. The mean surgery time was 72.9 min, the mean energy used was 230705 W, the mean laser time was 32 min. One patient required postoperative intensive care unit admission due to a chest infection, one required blood transfusions, three developed UTIs, and one developed urethral stricture. The mean maximum urinary flow rate pre- and postoperatively was 9.7 mL/s and 13.1 mL/s, respectively (statistically significant by repeated measure ANOVA; P < 0.05). In patients with a prostate size of <100 mL, 90% were fully satisfied. All patients would recommend this procedure to others. In patients with a prostate size of ⩾100 mL, 19 were fully satisfied, two were not satisfied, and three did not complete the questionnaire. Conclusion: PVP with 180-W GreenLight XPS laser is an effective and safe modality of treatment in high-risk patients with BPH whatever the size of the prostate. Prospective randomised controlled studies with more patients are needed to further confirm these results

[50] The efficacy and safety of low-intensity shockwave therapy in erectile dysfunction

Objective: To assess the effectiveness and safety of low-intensity extracorporeal shockwave therapy (Li-ESWT) on patients with erectile dysfunction (ED). Methods: This prospective single-centre study included 21 male patients between January 2015 and October 2017. All patients were aged >18 years and in a stable sexual relationship. They had been diagnosed with ED for ⩾6 months and still not satisfied with oral or intracavernosal injection treatment of their ED. Patients who had penile surgery, coagulopathy abnormalities, unstable or uncontrolled medical or psychiatric disorders, with neurological disorders, post radical pelvic surgery, on hormonal therapy or post pelvic radiation were excluded. The treatment course comprised of two phases using a low-energy shockwave generator, each for 3 weeks with two sessions each week (total 6 sessions) with a 3-week break, and total course duration of 9 weeks. Li-SWT was applied at 19 penile sites, each session delivering 3000 J to the patient’s penis, divided between the 10 points (each 300 J). The energy administered was 0.7–0.25 mJ/mm2 depending on the patient’s tolerability. Patients were in the supine position with no anaesthesia given. The outcome was assessed using the International Index of Erectile Function-Erectile Function (IIEF-EF) score before and after treatment. Results: In all, 21 patients were included in the study, with mean age of 43.9 years. Diabetes mellitus was present in 66.6%. All patients had sexual desire, with 95.25% having orgasmic function. All patients completed the first phase of treatment, and 71.4% felt an improvement and completed the second phase. The mean base IIEF-EF score for all patients was 10.14, which increased to 10.73 after the first phase. The IIEF-EF score rose to 12.8 in 15 of 21 patients who completed the full treatment course. About 66.6% of the patients would repeat the treatment and recommend it to a friend. Only one patient had mild ecchymosis and pain after treatment, which was treated conservatively. Conclusion: Li-SWT is a safe modality for ED and could be an effective treatment with minimal changes that could be beneficial with other non-surgical management strategies such as oral and intracavernosal injection treatments

Endocrine Complications and the Effect of Compliance with Chelation Therapy in Patients with Beta Thalassemia Major in Eastern Province of Saudi Arabia

Fatema Habbash,&ast; Wegdan Al-Bati,&ast; Howra Al-Hashim,&ast; Maryam Aldossari,&ast; Ahmed Alali, Khalid Alalyani, Zainab Al-Ebrahim, Nouf Hamed, Samma Eraqe, Ziyad Binayfan, Azzam Al Marri, Thamer Aljaber Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain&ast;These authors contributed equally to this workCorrespondence: Maryam Aldossari, Tel +966 558322420, Email [email protected]: Endocrinopathies and metabolic complications are common in beta thalassemia major patients receiving blood transfusions. Chelation therapy has a role in preventing or delaying such complications. However, patients may face difficulties adhering to chelation therapy for several reasons.Aim: To evaluate endocrine complications in beta thalassemia major patients (2– 30 years) in the Eastern Province of Saudi Arabia and compare the onset of endocrine complications among compliant and noncompliant patients. Moreover, we assessed the barriers that hinder compliance with chelating therapy.Methods: A cross-sectional study was conducted on 89 patients (43 males and 46 females) aged 2 to 30 years attending different hospitals in the Eastern Province of Saudi Arabia. A semi-structured questionnaire was used to collect demographic data and medical histories. The questionnaires were completed by face-to-face interviews with the patients or their caregivers, and the required laboratory data were retrieved from the medical records of patients.Results: The most prevalent abnormality was underweight detected in (40.9%) of patients, followed by subclinical hypothyroidism (37.7%), short stature (35.2%), hypothyroidism in (17.0%) and diabetes mellitus in (13.6%). A significant difference between those who were compliant with iron chelation therapy and those who were not in terms of the prevalence of short stature (P value= 0.05) and hypothyroidism (P value= 0.05). The percentage of patients who were not compliant with chelation therapy was 21.6% and 9.1% of patients were not taking them at all.Conclusion: Despite the role of chelation therapy in the management of iron overload, the risk of secondary endocrine and metabolic complications remained considerable. Subclinical hypothyroidism and short stature were the most frequent endocrine complications encountered in this study.Keywords: iron overload, metabolic complications, hereditary blood diseases, blood transfusion

Real-World Evaluation of Demographics, Treatment Pattern, and Economic Burden of Heart Failure and Kidney Disease in Type 2 Diabetes Mellitus Patient Population in Dubai, United Arab Emirates

Aims: The current study evaluated the demographics, clinical characteristics, treatment patterns, and economic burden of patients with type 2 diabetes mellitus (T2DM) with comorbidities (heart failure [HF], chronic kidney disease [CKD], and cardiovascular disease [CVD] without HF) in Dubai, United Arab Emirates (UAE). Methods: This observational, retrospective study collected data from January 01, 2014, to December 31, 2019, from the Dubai Real-World Claims Database (adults ≥18 years; at least 1 T2DM diagnosis claim). Patients were stratified into 5 cohorts: T2DM alone (cohort 1), T2DM and CKD (cohort 2), T2DM and CVD without CKD and HF (cohort 3), T2DM and HF (cohort 4), and T2DM with HF and CKD (cohort 5). An evaluation of demographics and clinical characteristics during pre-index period, as well as treatment patterns, healthcare resource utilization, and costs during the post-index period was conducted. Results: The sample had 374,271 patients with T2DM (age 43–56 years; male [72–84%]). Patients in cohorts 4 and 5 had Deyo-Charlson Comorbidity Index scores of 4.4 and 5.8, respectively. General practitioners (GPs) routinely prescribed biguanides for patients in cohorts 1–4 (24–38%), and insulin to patients in cohort 5 (27.7%). Prescription rates of novel antihyperglycemic drugs, such as glucagon-like peptide-1 (GLP-1 RA), were very low (∼2–8%) even in cohorts with cardiovascular and renal comorbidities (cohorts 2–5). A similar observation was noted with prescribing rates (0.6–4.4%) of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in cohorts 2–5. Endocrinologists preferred to prescribe GLP-1 RA and SGLT2i to T2DM patients with comorbidities. During the 5-year study period, median outpatient claims were the highest in cohort 5 (8.0 [range, 1.0–168.0]), followed by cohort 2 (5.5 [range, 1.0–52.0]). The median cost for inpatient claims was higher in cohort 5 (16,429 [range, 3,732–29,126] AED) compared to other cohorts. The median cost for drugs and procedures was highest in cohort 5 (4,525 [range, 38–31,546] AED and 2,297 [range, 56–105,074] AED, respectively). Conclusion: Continued and increased usage of drugs such as SGLT2i and GLP-1 RA with proven cardiorenal benefits could improve long-term outcomes and reduce associated healthcare costs in patients with T2DM and comorbidities in Dubai, UAE

Genetic and Morphological Diversity Assessment of Five Kalanchoe Genotypes by SCoT, ISSR and RAPD-PCR Markers

Determining the appropriate parents for breeding programs is the most important decision that plant breeders must make to maximize the genetic variability and produce excellent recombinant genotypes. Several methods are used to identify genotypes with desirable phenotypic features for breeding experiments. In this study, five kalanchoe genotypes were morphologically characterized by assessing plant height, number of inflorescences, number of flowers, flower length, flower diameter and number of petals. The analysis showed the distinction of yellow kalanchoe in the plant height trait, while the orange kalanchoe was distinguished in the number of inflorescences, the number of flowers and flower length traits, whereas the violet kalanchoe possessed the largest flower diameter and the highest number of petals. The molecular profiling was performed by random amplified polymorphism DNA (RAPD), inter-simple sequence repeats (ISSR) and start codon targeted (SCoT)-polymerase chain reaction&nbsp;(PCR) tools. Genomic DNA was extracted from young leaves and the PCR reactions were performed using ten primers for each SCoT, ISSR and RAPD marker. Only four out of ten primers showed amplicon profiles in all PCR markers. A total of 70 bands were generated by SCoT, ISSR and RAPD-PCR with 35 polymorphic bands and 35 monomorphic bands. The total number of bands of RAPD, ISSR and SCoT was 15, 17 and 38, respectively. The polymorphism percentages achieved by RAPD, ISSR and SCoT were 60.25%, 15% and 57%, respectively. The cluster analysis based on morphological data revealed two clusters. Cluster I consisted of violet and orange kalanchoe, and cluster II comprised red, yellow and purple kalanchoe. Whereas the cluster analysis based on molecular data revealed three clusters. Cluster I included only yellow kalanchoe, cluster II comprised orange and violet kalanchoe while cluster III comprised red, and purple kalanchoe. The study concluded that orange, violet and yellow kalanchoe are distinguished parents for breeding economically valued traits in kalanchoe. Also, the study concluded that SCoT and RAPD markers reproduced reliable banding patterns to assess the genetic polymorphism among kalanchoe genotypes that consider the basis stone for genetic improvements in ornamental plants