Cell-free DNA in Embryo Culture Media as Non-invasive Biomarker of the Quality of Embryo Cleavage

Background: The success of in vitro-fertilization (IVF) cycles is determined in large part by the quality of embryo cleavage, which in turn, is dependent on the quality of the embryo culture media (CM). Many factors can influence the quality of embryo CM, one of which is the levels of Cell Free Deoxyribonucleic acid (DNA). Understanding the association between Cell-free DNA levels in embryo CM and the quality of embryo cleavage could help improve the quality of IVF techniques. Methods: This prospective study was conducted with 96 spent CM from patients undergoing IVF cycle, in order to determine relationships of Cell-free DNA levels in embryo CM with embryo cleavage quality on day 3. After intracytoplasmic sperm injection (ICSI), 48 embryos were evaluated on day 3 of their development, according to their cell number. Day 2 and day 3 CM corresponding to each one of the embryos was analyzed, by quantitative PCR, for estimation of Cell-free DNA levels. Results: The results revealed a significant increase in Cell-free DNA levels on day 2 CM corresponding to 4 to 6 cell embryos compared to those corresponding to 7 to 8 cell embryos (p=0.04). As for day 3 CM, the results showed no significant difference between the Cell-Free DNA levels in CM of 7-8 and those of 4-6 cell embryos (p=0.4). Also, cell free DNA levels in embryo CM, were significantly higher on day 2 compared to day 3 for both 7-8 and 4-6 cell embryos (p=0.03; p=0.04). Conclusion: We conclude that cell-free DNA levels in CM might be associated with delayed embryo cleavage.

Lipid Peroxidation Status in Embryo Culture Media: The Impact on Fertilization and Embryo Quality during IVF Cycles

Background: The process of preimplantation embryo development in vitro represents a key phase during in vitro fertilization (IVF) cycles. It involves several regulatory signaling pathways as well as an optimized in vitro culture system. The resulting embryo quality helps to determine embryo competence before implantation and pregnancy outcomes. Reactive oxygen species (ROS) are known to play a major role in influencing the process of embryo development. Their role can be reflected in the regulation of signaling pathways as second messengers or in the irreversible cell alterations due to oxidative stress following an excess of ROS levels. Methods: In this study, we investigated the association between morphological embryo quality (fertilization, cleavage quality, and fragmentation levels) and lipid peroxidation levels (Malondialdehyde) in embryo culture media. After intracytoplasmic sperm injection (ICSI), a total of 103 oocytes were evaluated on day 1 and day 3 of their development, and their corresponding culture media were analyzed by estimating MDA levels using thiobarbituric acid. Results: The results showed no significant association between MDA levels in culture media and fertilization rate (p=0.3), sperm quality (p=0.99; p= 0.17; p=0.46; p=0.30; p=0.65; p=0.44; p=0.09; p=0.15; p=0.56), embryo fragmentation levels (p=0.79; p=0.40), AMH levels (p=0.31; p=0.36) and female age (p=0.60; p=0.34). However, we revealed a significant association between cleavage quality and MDA levels in the embryo environment (p=0.03). Conclusion: We conclude that oxidative stress in IVF culture media might be mainly associated with delayed embryonic development.

Renocila richardsonae Williams & Bunkley-Williams, 1992 (Isopoda: Cymothoidae), a parasite of Japanese goatfish, Upeneus japonicus off Sarawak, South China Sea

@#Renocila richardsonae Williams & Bunkley-Williams, 1992 is recorded for the first time from Sarawak coastal waters. During a survey of marine fishes at depth of 200 metres in South China Sea, off the coast of Sarawak from 3° to 5°N and 110° to 111°E, five specimens of Renocila richardsonae were collected from Japanese goatfish, Upeneus japonicus (Houttuyn, 1782) (Mullidae) with average prevalence of 17% and mean intensity of one isopod per fish from examination of 64 fish. The isopod was observed to cause tissue damage on the site of attachment to the host.

Hepatitis C virus and its genotypes in chronic liver disease patients from Meghalaya, Northeast India

Background and Objectives: Hepatitis C virus (HCV) is an important cause of chronic liver disease (CLD). Although Northeast India is believed to be a HCV hotspot, the proportion of HCV infection and the distribution of HCV genotypes in CLD cases from the region are not known. The objectives of the study were to determine the proportion of HCV infection in newly diagnosed CLD patients from Meghalaya, Northeast India, and further investigate the HCV genotype distribution in those patients. Materials and Methods: The aetiology of CLD was evaluated in 196 newly diagnosed patients, recruited consecutively over a period of 1 year in a medical college hospital from Meghalaya. Those positive for HCV infection were genotyped, and the mode of transmission of the virus was investigated. Results: A considerable proportion (43 patients, 21.9%) of CLD patients were positive for HCV (95% confidence interval [CI]: 16.7%–28.2%). Other leading causes of CLD were alcohol (36.32%) and hepatitis B virus infection (39.3%). Genotype 3 was the most prevalent (48.7%, 95% CI: 33.9%–63.8%), followed by genotype 6 (30.8%, 95% CI: 18.6%–46.6%) and genotype 1 (20.5%, 95% CI: 10.8%–35.5%). The frequency of genotype 6 was remarkably higher than in the other regions of India. Injecting drug use appeared to be the most common mode (28 patients) of acquiring HCV. This was true irrespective of the genotype. Conclusions: The presence of HCV in newly diagnosed CLD cases from Meghalaya was considerable. The genotype distribution of HCV was distinct from the other regions of India.

Amyotrophic lateral sclerosis: bilateral symmetrical signal abnormality of the corticospinal tracts on brain MRI: a case report

A 47 years old female patient presented with progressive muscular weakness of both legs and arms and dysarthria since few months, after excluding common causes [prolapsed cervical disc, spinal cord tumors and multiple sclerosis], diagnosed as a case of Amyotrophic lateral sclerosis [ALS] depending on clinical and MRI findings, which show striking symmetric hyper intensity in the corticospinal tracts. In this paper we present this case of ALS and highlight its clinical and radiological findings

Prevalence of neuropathy in the diabetic foot

To illustrate the prevalence of different types of neuropathy in diabetic patients with diabetic foot. This is a retrospective study of 229 diabetic foot patients treated at Princess Haya Hospital Hyperbaric Department, Aqaba, Jordan from January 1997 to January 2008, who were found to have different types of neuropathy. Neuropathy diagnosis was reached through investigating the patient's history by presence of pain, and clinical neurological examination, absence of ankle reflexes, and abnormal quantitative sensory testing. We found that 203 out of 229 [89%] patients had at least one type of neuropathy. One hundred and seventy-one out of 203 [84.2%] patients had symptoms of peripheral neuropathy, 11.8% of patients showed symptoms of different autonomic neuropathy, 2.5% of patients had been diagnosed with proximal neuropathy, and 1.5% had focal neuropathy. The mean age of diabetes in complicated neuropathy was 14.32 +/- 7.17 years. A stocking sensory loss was the leading symptom of peripheral neuropathy [77%] followed by symptoms of tingling, burning, or prickling sensations in 70% of patients. Symptoms and signs of peripheral neuropathy are considered the most important factors when counseling the diabetic patient, who should be thoroughly informed on the importance of applying ample care to the feet. The physician should consider the patient's age and chronicity of diabetes, and as they increase, it becomes imperatively important to conduct clinical examinations for early diagnosis of neuropathy

Quimioembolização transarterial hepática: modelo experimental de tumor em ratos / Transarterial hepatic chemoembolization: an experimental model in rats

OBJETIVO: Estabelecer um modelo de tumor no fígado de ratos para estudo do comportamento tumoral e avaliar o uso da quimiembolização transarterial. MÉTODOS: Utilizou-se oitenta e oito ratos Wistar, fêmeas, adultos, pesando entre 175- 284 g . Realizado incisão abdominal de 3 cm e implantou-se o carcinossarcoma de Walker 256 no lóbulo esquerdo do fígado. Dividiu-se em três grupos que receberam respectivamente 100x 10 , 200x 10 e 300x 10 células tumorais, avaliado a pega do tumor e a sobrevida. Em outro grupo de experimento com 39 animais inoculados com tumor de Walker foi avaliado a sobrevida dos animais após infusão do 5-Flourouracil (5-FU) por via intra-peritoneal e intra-arterial. RESULTADOS: O implante do carcinossarcoma de Walker no fígado de ratos apresentou desenvolvimento de 100 por cento, teve um crescimento rápido e desenvolvimento de metástases tardiamente, levando os animais ao óbito entre o sétimo e décimo quinto dia. A quimiembolização transarterial é possível de ser realizada experimentalmente. O uso do 5-FU aumentou a sobrevida em comparação ao grupo controle. CONCLUSAO: O modelo de implante do tumor de Walker no fígado de ratos é eficiente, de fácil reprodutibilidade, e sobrevida média de 9,96±0.3 dias. A quimioterapia transarterial hepática pode ser realizada experimentalmente para avaliar diversas drogas.

role of hyperbaric oxygen in managing ankle sprain

To confirm the efficacy of hyperbaric oxygen therapy in acute ankle sprain. This study was conducted at Princess Haya Al-Hussein Hospital's Hyperbaric chamber/Aqaba-Jordan, on 36 patients, treated in the Emergency Department. They had been divided according to the type of treatment into A, B and C. Group A had been treated at one absolute atmospheric pressure [1 ATA], group B at 2 ATA, and group C at 2.5 ATA. All groups received seven hyperbaric sessions, as outpatients in 5 consecutive days, twice a day for two days followed by once a day for the remaining three days, for a 90 minute-session. All patients with acute ankle sprain with no history of recurrent attacks, had been treated at 2.5 ATA [gtoup C] were completely free of pain and of swelling by the end of the last session. Hyperbaric oxygen therapy is the best choice for the rapid recovery of acute ankle sprain

Laboratory aspects of asymptomatic bacteriuria in pregnancy.

A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.