ABSTRACT
Aim of the study: was to investigate the effectiveness of Percutaneous Needle Aspiration in comparison to continuous catheter drainage in the treatment of hepatic abscesses
Methods: A review of the scientific literature [From 1980 to October 2017] MEDLINE, EMBASE, SCOPUS, Current Contents, Cochrane Library, and Clinicaltrials.gov were searched to identify randomized controlled trials that investigated thoroughly the Percutaneous Needle Aspiration Versus Catheter Drainage in the treating of hepatic abscess and clearly met the inclusion criteria and the study primary endpoints [success rate, total resolution and mortality]. Identification of papers and data extraction were performed by independent researchers
Results: the search yielded six eligible RCTs covering 348 patients. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [RR: 0.79, 95% CI=0.64-0.97; P = 0.04], days to achieve a 50% reduction in abscess cavity size [SMD: ?1.076, 95% CI 0.63-1.51; P < 0.00001] and overall clinical improvement [SMD: 0.71, 95% CI 0.35-1.09; P =0.0001]. On the other hand, no significant difference was notable in the duration of hospitalization [SMD: -0.15, 95% CI -2.03 to 1.72, P = 0.84] or procedure-related complications [RR: 0.48, 95% CI 0.13-2.58; P = 0.39]
Conclusion: The results of the present meta-analysis and systematic review indicated that PCD and PNA can be less safe and less invasive methods for the treatment of hepatic abscesses yet PCD is suggested to be more advantageous and superior to PNA
ABSTRACT
To evaluate the outcome of testicular biopsies as well as the etiology of azoospermia and severe oligospermia in Saudi men referred for tertiary care. To correlate testicular histology with patients' clinical and hormonal profiles. Charts of men subjected to testicular biopsies in the last 10-year period were retrospectively reviewed. Relative history and physical examination findings were reported. Results of male fertility profile tests and semen analysis of at least two ejaculates were collected. Reported histopathology was obtained. Reports of 229 patients were included; 199 [86.9%] with azoospermia and 30 [13.1%] with severe oligospermia. The mean [SD] age was 30.6 [6.4] years. A small right or left testis was reported in 88 [38.4%] and 87 [38%] of the patients, respectively. The mean [SD] testosterone and follicle stimulating hormone [FSH] values were 17.2 [7.2] nmol/L and 13.1 [10.9] IU/L, respectively. Hypospermatogenesis was the most common histology encountered [36.5%], followed by Sertoli cell-only [SCO] histology [31.5%]. Low testicular volume [P = 0.000], high FSH [P = 0.001] and high leutenizing hormone [LH] [P = 0.001] were found to be of significantly adverse effect on spermatogenesis. Despite having bilateral small testes, high serum FSH and LH, 24.3% of our patients showed active spermatogenesis. Hypospermatogenesis was the most common pattern of spermatogenic defect in our patients. SCO histology was the most common pattern in patients with small testes, primary testicular failure, primary infertility and azoospermia. Low testicular volume, high FSH and LH are significantly associated with impaired spermatogenesis. Even with severe male factor infertility disorders, infertile men can have some spermatogenesis