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Objective@#The sperm DNA fragmentation index (DFI) guides the clinician’s choice of an appropriate assisted reproductive technology (ART) procedure. The DFI can be determined using commercially available methodologies, including sperm chromatin dispersion (SCD) kits and sperm chromatin structure assay (SCSA). Currently, when DFI is evaluated using SCD kits, the result is analyzed in reference to the SCSA-derived threshold for the choice of an ART procedure. In this study, we compared DFI values obtained using SCSA with those obtained using SCD and determined whether the difference affects the choice of ART procedure. @*Methods@#We compared SCSA to two SCD kits, CANfrag (n=36) and Halosperm (n=31), to assess the DFI values obtained, the correlations between tests, the technical repeatability, and the impact of DFI on the choice of ART. @*Results@#We obtained higher median DFI values using SCD kits than when using SCSA, and this difference was significant for the CANfrag kit (p<0.001). The SCD kits had significantly higher coefficients of variation than SCSA (p<0.0001). In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) would be chosen for a significantly higher proportion of patients if a decision were made based on DFI derived from SCD rather than DFI determined using SCSA (p=0.003). @*Conclusion@#Our results indicate that SCD kit-specific thresholds should be established in order to avoid the unnecessary use of IVF/ICSI based on sperm DNA damage for the management of infertility. Appropriate measures should be taken to mitigate the increased variability inherent to the methods used in these tests.
RESUMEN
Objective@#The sperm DNA fragmentation index (DFI) guides the clinician’s choice of an appropriate assisted reproductive technology (ART) procedure. The DFI can be determined using commercially available methodologies, including sperm chromatin dispersion (SCD) kits and sperm chromatin structure assay (SCSA). Currently, when DFI is evaluated using SCD kits, the result is analyzed in reference to the SCSA-derived threshold for the choice of an ART procedure. In this study, we compared DFI values obtained using SCSA with those obtained using SCD and determined whether the difference affects the choice of ART procedure. @*Methods@#We compared SCSA to two SCD kits, CANfrag (n=36) and Halosperm (n=31), to assess the DFI values obtained, the correlations between tests, the technical repeatability, and the impact of DFI on the choice of ART. @*Results@#We obtained higher median DFI values using SCD kits than when using SCSA, and this difference was significant for the CANfrag kit (p<0.001). The SCD kits had significantly higher coefficients of variation than SCSA (p<0.0001). In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) would be chosen for a significantly higher proportion of patients if a decision were made based on DFI derived from SCD rather than DFI determined using SCSA (p=0.003). @*Conclusion@#Our results indicate that SCD kit-specific thresholds should be established in order to avoid the unnecessary use of IVF/ICSI based on sperm DNA damage for the management of infertility. Appropriate measures should be taken to mitigate the increased variability inherent to the methods used in these tests.
RESUMEN
Stevens-Johnson Syndrome (SJS) is an acute hypersensitive reaction and a life-threatening condition affecting both skin and mucous membranes. We report a case with SJS likely induced by Chlordiazepoxide. The patient undergoing treatment for acute pancreatits is prescribed with Chlordiazepoxide after administering the patient reported mild pyexia with lesions all over the body with redness. Mild peeling of the skin due to rupture of the lesions and pigmentation on the skin was observed for 3 days. Based on these finding he was diagnosed with Chlordiazepoxide induced Stevens-Johnson syndrome. The patient was administered systemic steroid therapy and treated symptomatically. Here we describe a case of Chlordiazepoxide induced SJS in acute p ancreatitis patient.
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Background: Pain is the most common cause of needle Phobia. In order to overcome this many advanced injection techniques has been implemented. The most recent and advanced technique was using a small vibrating device to the conventional injection technique. Objectives: To evaluate the efficacy of vibraject versus conventional injection technique. Material and methods: Prospective, randomized, cross- over, single blinded design was carried out among adults above 18 years of age in private hospital in Chennai city, Tamil Nadu, India. Out of 52 subjects, 37 were willing to participate in the study. Split mouth technique was carried out. A calibrated single examiner used an appropriate amount of anaesthetic solution, 2% lidocaine with 1:100,00 dilution of epinephrine was injected slowly and then patient was asked to report their discomfort and pain was noted using verbal descriptor scale. Sign test was calculated to check the efficacy of vibraject to that of conventional injection technique. Results: The total sample size consists of 37 study subjects. Out of total study subject, 35 subjects reported increased pain score while using conventional injection technique than using vibraject with a significant difference (Z=-5.5, p=0.00). Out of total study subject, 14 subjects reported increased pain score while using conventional injection technique than using vibraject. The p value for 2-tailed sign test shows (p=0.04) there was significant difference between two techniques. Conclusion: Vibraject has significantly reduced pain both during insertion of needle and during deposition of solution when compared to the conventional injection technique.
RESUMEN
Bulgaria es un país excomunista en un período de profundareforma social que afecta de igual manera la moral. Este trabajo tiene por objeto hacer un bosquejo del desarrollo contemporáneoy de los problemas de la Bioética en Bulgaria.
Bulgaria is an ex-communist country in a period of profound social reform which affects morality as well. This paper aims at making an outline of contemporary development and problems of bioethics in Bulgaria.