Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.

Entropy-guided end-tidal desflurane concentration during living donor liver transplantation

The three phases of living donor liver transplantation [LDLT] represent different liver conditions. The aim is to study the required end-tidal desflurane concentration [ET-Des] guided with entropy monitoring for the depth of anesthesia. After the Ethics and Research Committee approval, 40 patients were included in this prospective study. Anesthesia was maintained with Desflurane-O2-air. State entropy [SE] and Response entropy [RE] were kept between 40 and 60. Age and Model for End-stage Liver Disease [MELD] score were 45 +/- 10 years and 15.43 +/- 3.92, respectively. ET-Des were significantly lower in the anhepatic phase [2.8 +/- 0.4%] than in the pre-anhepatic and neohepatic phases [3.3 +/- 0.3%, 3.47 +/- 0.3%, respectively, P<0.001]. The SE and RE for pre-anhepatic, anhepatic, and neohepatic phases were [45.6 +/- 3.7, 47.4 +/- 3.2], [44.7 +/- 2.1, 46.4 +/- 2.04], and [46.1 +/- 3.3, 47.9 +/- 3.3], respectively, with no significant changes between the phases, P > 0.05. Total operative time was 651 +/- 88 minutes, and for each phase it was 276 +/- 11, 195 +/- 55, and 191 +/- 24 minutes, respectively. Significant changes were found in hemoglobin g/dl and hematocrit% between the three phases [10.28 +/- 1.5, 30.48 +/- 4.3], [9.45 +/- 1.34, 28.36 +/- 4.1], and [8.88 +/- 1.1, 26.63 +/- 3.5], P<0.05. The heart rate and mean blood pressures were stable despite the cardiac index demonstrated a significant reduction during the anhepatic phase [2.99 +/- 0.22] when compared to the pre-anhepatic and neohepatic phases [3.60 +/- 0.29] and [4.72 +/- 0.32], respectively, [P<0.05]. There was a significant correlation between CI and ET-Des% [r=0.604, P<0.05]. Inhalational anesthetic requirements differed from one phase to another during LDLT, with requirements being the least during the anhepatic phase. Monitoring of the anesthesia depth was required, to avoid excess administration, which could compromise the hemodynamics before the critical time of reperfusion

External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section

The incidence of caesarean section for breech presentation has increased markedty in the last 20 years. A prospective, interventional cohort study was carried out of the success rate of external cephalic version [ECV] and its predictors of as well as its impact on the rate of caesarean section for vaginal breech delivery. All 128 women admitted during the study period to the obstetrics department of a tertiary care military hospital in Taif Saudi Arabia with breech presentation at term, regardless of age and parity, who accepted ECV were recruited ECV was successful in 53.9% of the women. Most of the women with successful ECV delivered normally [84.1%] and only 14.5% of them delivered by caesarean section. Conversely, normal vaginal delivery was reported among 8.5% of those who had spontaneous version with failed ECV and approximately two-thirds of them delivered by caesarean section [62.7%]. Successful ECV reduced the breech and caesarean section rate

Habitat characteristics for different freshwater snail species as determined biologically through macroin- vertebrate information

Macro-invertebrates including freshwater snails collected from 643 sites over 8 successive seasons among the River Nile, branches, main canals and certain drains in eight Egyptian Governorates. Thirteen snail species and one bivalve species were identified. The most distributed were Lanistus carinatus and Physa acuta while the most abundant were Cleopatra bulimoides and Physa acuta during the whole study. The sites that harbored each snail species in all the examined watercourses were grouped seasonally and their biological assessment was determined by their minimum and maximum total point similarity percentage to that of the corresponded reference site and mean of the total points. Habitats for most snail species attained minimum total point's similarity percentage less than 21% [very poor habitat] during autumn and winter then spring while during summer very poor habitat was harbored by only few snail species. P. acuta was the only survived snails in habitat which attained 0 as a minimum total point's similarity percentage during two seasons and L. carinatus and Succinea cleopatra during one season. With respect to medically important snails very poor sites constituted 23% of Biomphalaria alexandrina sites, 14% of Lymnaea natalensis and 9.4% of Bulinus truncatus sites. The studied macroinvertebrate matrices, total number of organisms, taxa richness, the Ephemeroptera, Plecoptera, and Trichoptera [EPT] index, ratio of EPT index to chironomidae, ratio of scraper to filtering collector, contribution of dominant macroinvertebrate major group, comparison revealed descending tolerances from B. alexanrina followed by L. natalensis then B. truncates, but Hilsenhoff Biotic Index [HBI] showed the same tolerance to organic pollution

Chemical and biological assessment for Egyptian surface freshwater environment with reference to human activities

The Egyptian freshwater was assessed in the River Nile, branches, main canals and certain drainages in eight Governorates, over eight successive seasons starting from spring 2008. Chemical assessment was made through ten parameters and the biological one was made through macro-invertebrates information. Results showed that means of Cd, Pb, Cu, Hg, Mn, Fe, Ni, Na, K and Ca varied in watercourses seasonally within somewhat narrow ranges, which may exceed the level of concern but with some elevations in branches, Rayahs and canals during certain seasons. Sites showed chemical levels over the permissible one or those gain total points

Serum interleukin-8 and insulin-like growth factor-1 in Egyptian bladder cancer patients

Bladder cancer is a major health problem in Egypt as it represents the most common malignancy. The increasing morbidity and mortality rates of bladder cancer have forced the scientists to zearch for new unfailing diagnostic and therapeutic methods that will improve treatment effects. Insulin-like growth factor-1 [IGF-1] and Interleukin-8 [IL-8] have been implicated in the development of various human cancers. To evaluate the potential usefulness of serum IGF-1 and IL-8 in Egyptian bladder cancer patients. serum levels of IL-8 and IGF-I were determined in 51 bladder cancer patients and 45 controls using a chemiluminescence enzyme immunometric assay. Serum IL-8 was significantly higher in cancer patients than in controls [p<0.0001]. It was significantly higher in patients with invasive cancer than those with superficial cancer [p<0.01]. In addition, IL-8 showed a significant elevation in relation to schistosomal infection [p=0.02] however, it did not differ in relation to either pathological type of tumor or its grade [p>0.05]. Receiver operating characteristic [ROC] curve indicated that IL-8 cutoff value of 28 pg/mi yielded the best sensitivity [76.5%] and specificity [84.4%] for differentiating patients with bladder cancer from control subjects. Serum IGF-1 levels showed no significant difference between bladder cancer patients and controls [p>0.05]. There was no relationship between IGF-1 levels and clinicopathological parameters. In Egyptian patients with bladder cancer, serum IL-8 was significantly elevated and its level was related to tumor invasion and associated schistosomal infection. Moreover, serum IGF-1 level did not help as a serum tumor marker in these patients

association between fresh water snails, macrophytes and water quality in different water courses in Egypt

The pattern of association between freshwater snails and macrophytes in relation to some water quality parameters were studied in 258 sites representing the Nile River. main branches, canals and drainages in Menia. Giza. Helwan, Cairo. Qalyubiya, Esmailia. Behaira and Damietta Governorates during May 2008 - March 2009. The survey study collects 15 aquatic plant species and 13 snail species. Statistical analysis showed high significant correlation between snails and plants [r = 0.462]. The examined sites were divided into four categories, sites with plant only [20%], sites with snails only [7%], sites free from both plants and snails [9%] and the biggest category which include sites with both plants and snails [64%]. Results showed that free sites characterized by the highest concentrations of cadmium, lead, mercury, sodium and potassium. Plant sites were characterized with the highest concentration of dissolved oxygen. Snail sites characterized with highest concentration in calcium. Sites in which snails associated with plants were characterized with higher ranges of chemicals, dissolved oxygen and conductivity than that observed in sites with snails only and this indicates the helpful role of plants for increasing snail tolerance to unfavorable conditions

Comparison of induction and recovery charcteristics of sevoflurane and halothane in pediatric ansthesia

Forty children ASA I-II, aged 3-9 years scheduled for adenotonsillectomy were randomly divided into two equal groups [each group 20 patients] according to whether they induced and maintained with halothane and sevoflurane. The comparison was between the two groups as regards induction, recovery characteristics, hemodynamic changes as well as complications happened during induction and recovery. Anesthesia was induced using graded inhalation technique with either halothane up to 5% and sevoflurane up to 8%. Maintenance was achieved by 1.5-2% halothane and 1-4% sevoflurane. The times of induction and emergence were significantly shorter in sevoflurane as compared with halothane group. The better intubation conditions were observed in patients who received halothane anesthesia with no statistically significant difference. The hemodynamic changes were similar in both groups with improved cardiovascular profile in sevoflurane group. There was no significant difference between the two groups as regards airway complications during induction and recovery. The conclusion of the study is that sevoflurane could be used safely as an alternative to halothane in pediatric anesthesia

Clinical evaluation of dexamethasone versus methylprednisolone for reducing postoperative Inflammatory sequelae following third molar surgery

Ninety patients were enrolled in the study and randomly assigned to one of three groups. Thirty patients received dexamethasone [4 mg] 5-10 minutes preoperatively. Thirty patients received methylprednisolone [125 mg] 5-10 minutes preoperatively. Thirty patients served as controls [received no steroids]. The duration of facial swelling was evaluated subjectively by the patients. Severity of postoperatively pain was quantified by counting the number of analgesics that the patients took on the day of surgery and during the subsequent six days after surgery. Trismus was determined by measuring the maximal incisive opening before operation and on the seventh postoperative day. It was found that the duration of facial swelling was almost the same in the three test groups. On the day of surgery, the methylprednisolone group showed less significant pain than the other two groups, and the dexamethasone group showed less marked postoperative increase in the incisive opening over the control group. Trismus was significantly reduced in the methylprednisolone group as compared to the dexamethasone group

Determinants of geographic tongue in patients with asthma

The study was conducted on 72 patients with asthma who attended the Asthma follow-up Clinic in King Abdel-Aziz University Hospital during one month. Diagnosis of bronchial asthma was confirmed through medical history, nature of the episodic attacks, complaints during attacks, chest X-ray, and lung function measurements before and after salbutamol inhalation. Total IgE level was determined for all patients. Detailed personal and clinical information were obtained on each patient. The presence of geographic tongue was checked through intraoral examination. The study showed high prevalence of geographic tongue [18%] among the asthmatic patients. Geographic tongue lesions were encountered more frequently among young patients, with no sex predilection. There was no significant tendency of occurrence of geographic tongue in patients with raised IgE levels, nor in those with known allergic disorders. Of interest, was the finding that geographic tongue was exclusively detected in patients with mild and episodic asthma, while no tongue lesions were detected in those with severe and chronic asthma

Blood pressure response to dental extraction

The purpose of this study was to evaluate blood pressure response to dental extraction in normotensive and hypertensive patients. 55 patients [23 normotensive and 32 mild hypertensive] were investigated. For every patient, systolic and diastolic blood pressure values were measured at 2-minutes intervals from 10 minutes before anesthesia until 10 minutes after the extraction was completed. The results showed that there is marked intraindividual variability in blood pressure response to dental treatment. Some individuals showed stable, or nearly stable blood pressure values, while others showed large up and down, systolic as well as diastolic fluctuations across the whole treatment period. Statistical analyses indicated that the observed variability is not related to patients' age, sex or blood pressure status [normotensive or hypertensive], and is not affected by the magnitude of dental intervention. Identification of those individuals with exaggerated blood pressure response might be of potential clinical significance, specially in hypertensive patients. Further investigations are needed to evaluate blood pressure response of moderate and severe hypertensive patients during dental treatment

Reliability of caries prevalence in the determination of bitewing radiographic intervals

The objective of the present study was to evaluate the reliability of caries prevalence in the prediction of future caries activity, and hence, in the determination of bitewing radiographic intervals. DMFS scores of an adult patient population were determined and subsequently related to their caries activity detected one year later using posterior bitewing radiographs. The results showed that caries activity was not limited to those with baseline high caries prevalence [DMFS scores > 20]. Significant proportions of those initially classified as moderate [DMFS score between 5 and 20] or low [DMFS score < 5] caries prevalent, showed caries activity as well, and accounted for more than 50% of the newly developed carious lesions one year later. In all, initial DMFs score could account for only 17% of the variations in caries increment. On the other hand, all of the newly developed carious lesions were confined to the enamel regardless of the initial patient classification as high, moderate or low caries prevalent. The results indicated that caries prevalence is not a satisfactory predictor of future caries activity, and so, might not be a reliable parameter in the determination of bitewing radiographic intervals. The clinical implications of the findings are discussed

Frequency and distribution of medical problems in an adult dental population

The purpose of the present study was to determine the frequency of medical problems and their distribution in different age groups within an adult population of dental patients. Medical histories of 1100 patients were obtained and analyzed. In all, 59.8% of the patients were healthy, 25.9% had one medical problem, 9.7% had two and 4.6% had three or more medical problems. As well, 27.8% of the patients were on occasional or long-term medications for their medical problems, the most frequently noted medical problems were allergy, hypertension, diabetes, cardiovascular and respiratory diseases. With age, the incidence of medical problems as well as the percentage of patients with multiple problems increased. Hypertension, cardiovascular diseases and diabetes increased dramatically in older age groups. The recognized high incidence of medical problems in the dental population studied suggested an increased risk of complications during dental treatment, and further supports the importance of evaluating the medical status of dental patients before treatment

Anthropometric characteristics of the upper Egyptian newborns in comparison with other countries

A sample of 151 full term infants [89 males and 62 females] was taken from Minia district of Upper Egypt. The infants were subjected to different anthropometric measurements within 24 hours after birth. It appeared that there were no significant differences in the various body measurements between male and female newborns except for skin-fold thickness where female values were significantly greater than male values. Considering that the fat tissue is laid down only during the last weeks of gestation, this represents a marked sex difference. In comparison with some anthropometric measurements of newborn infants elsewhere, the present sample did not show any significantly retarded growth measurement. This indicates that the indicators of growth welfare of the Upper Egyptian newborns are promising and inore attention should be made to the postnatal period