Epidemiological Features of Cutaneous Leishmaniasis in Zliten (North West of Libya)

Cutaneous Leishmaniasis is endemic in north-west of Libya forlong time andit’s spread to other new foci continues to involve new areaslike Taurgha, Sirt and recently, Zliten. Most ofthe patients in north-west of Libya were infected with zoonoticCutaneous Leishmaniasis, which caused by leishmania major, althoughsome cases of anthroponotic cutaneous leishmaniasis caused by leishmania tropica were also reported. Zliten is a coastal city in the north west of Libya;with more than 289000 people; and now isknown to be a new focus since 2016 when the sudden increase of the number of patients with Cutaneous Leishmaniasis had occurred. Aims: This study was performed to observe epidemiological changes about incidence, age of patients, geographical distribution in Zliten city over a period of last 2 year (2017 and 2018).Study Design:Cross-sectional study as retrospective study over time of twoyears, involving all patients, who were presented or referred, to get management of Cutaneous Leishmaniasis, in three accredited outpatient departments for cutaneousleishmania (in Zliten). The data were collected and analyzed in Zliten Teching Hospital.Place and Duration of Study: Outpatient Department of Dermatology and Venereology of Zliten Teaching Hospital between 1stJanuary 2017 and 31stDecember 2018.Methodology: The study included all patients (different gender and from all age groups) withCutaneous Leishmaniasis, who sought medical advicein dermatology reference clinics in Zliten over the period of 2 years (2017 and 2018). The main collected data were age, sex, number of lesions, and affected sites in the body, residency of the patients, year and month of presentation. The analysis ofdata was made with the use of Statistical Package for the Social Sciences (SPSS 25).Results:Eight hundred thirty nine patients were included in this study. The majority of patients came from Zliten and these represented 95.6%, while the most of them came from Majer (south easternpart of Zliten City with more than 25000 people living in it) and represented 45.5% of total patients with CL included in this study, followed by Al-juma (south westernpart of Zliten with around 52000 people), represented (28%) of total patients with CL.Males were found to be more affected, with male to female ratio, 2.4:1. The most affected age group were these less than forty with peak incidence at age group (20 yrs to 30 yrs). The registered patients in 2017 were 397, this number had increasedslightly to be 440 in the following year (2018).The distribution of patients had shown seasonal variations, with steep increase in the number of cases in December, November and January.Conclusion:Cutaneous Leishmaniasis is remained to be amajor health problem in Zliten, affecting a large number of population every year and need further study to determine molecular identification of parasites, and more efforts are needed to control the vector and reservoir.

Nebulized heparin and salbutamol versus salbutamol alone in acute exacerbations of chronic obstructive pulmonary disease requiring mechanical ventilation: a double-blind randomized controlled trial / 대한마취과학회지

Background@#Nebulized heparin has been effectively used in the management of many pulmonary diseases. However, its effect on mechanically ventilated patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) has never been studied. This study aimed to assess the efficacy of nebulized heparin and salbutamol to increase ventilator-free days (VFD) in mechanically ventilated AECOPD patients and the effect of nebulized heparin on respiratory and coagulation functions. @*Methods@#In this double-blind controlled study, 60 mechanically ventilated adult patients with AECOPD were randomly allocated into two groups; heparin and salbutamol (HS) group and salbutamol only (S) group. In the HS group, patients received nebulized heparin (25,000 IU) and salbutamol (5 mg) every 6 hours. Patients in the S group received nebulized salbutamol only (5 mg). The treatment was continued while patients remained ventilated for a maximum of 14 days. The primary outcome was VFDs at day 14. PaCO2, PaO2/FiO2 ratio, number of nebulizations withheld, C-reactive protein (CRP) titer and activated partial thromboplastin time (APTT) were secondary outcomes. @*Results@#Patients in the HS group had significantly more VFDs (4.7 [3.3]) compared with those in the S group (2.4 [2.6]), P = 0.007. PaCO2 levels, PaO2/FiO2, the decrease in the CRP level and the increase in the APTT from the baseline were comparable in both groups. @*Conclusions@#The co-administration of nebulized heparin and salbutamol, compared with salbutamol alone, significantly increased (VFDs) among mechanically ventilated AECOPD patients without increasing bleeding risks.

Nebulized heparin and salbutamol versus salbutamol alone in acute exacerbations of chronic obstructive pulmonary disease requiring mechanical ventilation: a double-blind randomized controlled trial / 대한마취과학회지

Background@#Nebulized heparin has been effectively used in the management of many pulmonary diseases. However, its effect on mechanically ventilated patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) has never been studied. This study aimed to assess the efficacy of nebulized heparin and salbutamol to increase ventilator-free days (VFD) in mechanically ventilated AECOPD patients and the effect of nebulized heparin on respiratory and coagulation functions. @*Methods@#In this double-blind controlled study, 60 mechanically ventilated adult patients with AECOPD were randomly allocated into two groups; heparin and salbutamol (HS) group and salbutamol only (S) group. In the HS group, patients received nebulized heparin (25,000 IU) and salbutamol (5 mg) every 6 hours. Patients in the S group received nebulized salbutamol only (5 mg). The treatment was continued while patients remained ventilated for a maximum of 14 days. The primary outcome was VFDs at day 14. PaCO2, PaO2/FiO2 ratio, number of nebulizations withheld, C-reactive protein (CRP) titer and activated partial thromboplastin time (APTT) were secondary outcomes. @*Results@#Patients in the HS group had significantly more VFDs (4.7 [3.3]) compared with those in the S group (2.4 [2.6]), P = 0.007. PaCO2 levels, PaO2/FiO2, the decrease in the CRP level and the increase in the APTT from the baseline were comparable in both groups. @*Conclusions@#The co-administration of nebulized heparin and salbutamol, compared with salbutamol alone, significantly increased (VFDs) among mechanically ventilated AECOPD patients without increasing bleeding risks.

Levetiracetam and lamotrigine effects as mono- and polytherapy on bone mineral density in epileptic patients / Efeitos do levetiracetam e lamotrigina, em mono e politerapia, na densidade mineral óssea de pacientes epilépticos

ABSTRACT The purpose of this study was to determine the effect of lamotrigine (LTG) and levetiracetam (LEV) as mono- and polytherapy on biochemical markers of bone turnover and bone mineral density in Egyptian adult patients with epilepsy. Methods Forty-eight patients were divided into four groups: two received monotherapy of either LTG or LEV, and the other two groups received polytherapy comprising (valproate [VPA] + LTG or VPA + LEV). Thirty matched healthy participants were included in the study. Participants completed a nutritional and physical activity questionnaire. Biochemical markers of bone and mineral metabolism and bone mineral density of the lumbar spine were measured at baseline and at six months. Results In the LEV monotherapy group, the bone formation markers showed a significant decrease in serum alkaline phosphatase and serum osteocalcin levels while the bone resorption marker showed a significant increase in urinary deoxypyridinoline levels. After six months of treatment, bone mineral density showed a significant decrease in all treated groups, while among monotherapy groups, this significant decrease was more prevalent in the LEV monotherapy group compared with the LTG monotherapy group. Furthermore, there was significant negative correlation between urinary deoxypyridinoline levels and bone mineral density in the LEV monotherapy group. Conclusion Using new generation antiepileptics, LEV monotherapies and polytherapy showed harmful effects on bone but LTG did not.

RESUMO O objetivo deste estudo foi determinar o efeito da lamotrigina (LTG) e levetiracetam (LEV) como mono e politerapia em marcadores bioquímicos de remodelação óssea e densidade mineral óssea em pacientes adultos egípcios com epilepsia. Métodos Quarenta e oito pacientes foram divididos em quatro grupos: dois grupos receberam monoterapia de LTG ou LEV e os outros dois grupos receberam politerapia (valproato [VPA] + LTG ou VPA + LEV). Trinta participantes saudáveis controle foram incluídos no estudo. Os participantes preencheram um questionário nutricional e de atividade física. Marcadores bioquímicos do metabolismo ósseo e mineral e densidade mineral óssea da coluna lombar foram medidos no início e aos seis meses. Resultados No grupo de monoterapia LEV, os marcadores de formação óssea mostraram uma diminuição significativa nos níveis séricos de fosfatase alcalina e osteocalcina sérica, enquanto o marcador de reabsorção óssea mostrou um aumento significativo nos níveis de desoxipiridinolina urinária. Após seis meses de tratamento, a densidade mineral óssea mostrou uma diminuição significativa em todos os grupos tratados, enquanto entre os grupos de monoterapia, esta diminuição significativa foi mais prevalente no grupo de monoterapia LEV em comparação com o grupo de monoterapia LTG. Além disso, houve correlação negativa significativa entre os níveis de desoxipiridinolina urinária e densidade mineral óssea no grupo de monoterapia LEV. Conclusão Utilizando antiepilépticos de nova geração, as monoterapias LEV e a politerapia mostraram efeitos prejudiciais no osso, mas a LTG não.

Actiflagelin, a new sperm activator isolated from Walterinnesia aegyptia venom using phenotypic screening

Sperm contains a wealth of cell surface receptors and ion channels that are required for most of its basic functions such as motility and acrosome reaction. Conversely, animal venoms are enriched in bioactive compounds that primarily target those ion channels and cell surface receptors. We hypothesized, therefore, that animal venoms should be rich enough in sperm-modulating compounds for a drug discovery program. Our objective was to demonstrate this fact by using a sperm-based phenotypic screening to identify positive modulators from the venom of Walterinnesia aegyptia. Methods Herein, as proof of concept that venoms contain interesting compounds for sperm physiology, we fractionated Walterinnesia aegyptia snake venom by RP-HPLC and screened for bioactive fractions capable of accelerating mouse sperm motility (primary screening). Next, we purified each compound from the positive fraction by cation exchange and identified the bioactive peptide by secondary screening. The peptide sequence was established by Edman sequencing of the reduced/alkylated compound combined to LC-ESI-QTOF MS/MS analyses of reduced/alkylated fragment peptides following trypsin or V8 protease digestion. Results Using this two-step purification protocol combined to cell phenotypic screening, we identified a new toxin of 7329.38 Da (actiflagelin) that activates sperm motility in vitro from OF1 male mice. Actiflagelin is 63 amino acids in length and contains five disulfide bridges along the proposed pattern of disulfide connectivity C1-C5, C2-C3, C4- C6, C7-C8 and C9-C10. Modeling of its structure suggests that it belongs to the family of three finger toxins with a noticeable homology with bucandin, a peptide from Bungarus candidus venom. Conclusions This report demonstrates the feasibility of identifying profertility compounds that may be of therapeutic potential for infertility cases where motility is an issue.(AU)

Role of multi-slice CT in staging of neuroblastoma

Background: The International Neuroblastoma Risk Group Staging System [INRGSS] is a recent pretreatment staging system for neuroblastoma [NB], based on imaging by CT before surgery

Purpose: this study aimed to stage NB cases using CT scan, in relation to available clinicopathologic data

Patients and Methods: Twenty pathologically proven NB cases were included. All were reviewed for patients' characteristics, includingage; sex, clinical picture, LN status and metastatic spread. All cases underwent CT scan for diagnosis. Stagingwas done using IDRFs, LN status and metastatic spread according to the INRGSS and INSS when available

Results: an abdominal mass was found in 85% of cases and the suprarenal gland was the most common site of primary tumor [50% of cases]. Concerning tumor grade, 85 % of cases were poorly differentiated. LNs were positive in 70%, and metastatic spread was found in 35% of patients respectively. Staging according to the INRGSS showed that L2 was the most common stage [45% of cases], followed by M stage [35%]. L1 and MS stages were found in 15% and 5% of cases respectively. Only 7 cases had postsurgical CT scans, and were staged according to the INSS

Conclusion: it was concluded that the use of the INRGSS using CT scan, is a recent valuable pretreatment staging system, allowing accurate classification of neuroblastoma

Actiflagelin, a new sperm activator isolated from Walterinnesia aegyptia venom using phenotypic screening

Background Sperm contains a wealth of cell surface receptors and ion channels that are required for most of its basic functions such as motility and acrosome reaction. Conversely, animal venoms are enriched in bioactive compounds that primarily target those ion channels and cell surface receptors. We hypothesized, therefore, that animal venoms should be rich enough in sperm-modulating compounds for a drug discovery program. Our objective was to demonstrate this fact by using a sperm-based phenotypic screening to identify positive modulators from the venom of Walterinnesia aegyptia. Methods Herein, as proof of concept that venoms contain interesting compounds for sperm physiology, we fractionated Walterinnesia aegyptia snake venom by RP-HPLC and screened for bioactive fractions capable of accelerating mouse sperm motility (primary screening). Next, we purified each compound from the positive fraction by cation exchange and identified the bioactive peptide by secondary screening. The peptide sequence was established by Edman sequencing of the reduced/alkylated compound combined to LC-ESI-QTOF MS/MS analyses of reduced/alkylated fragment peptides following trypsin or V8 protease digestion. Results Using this two-step purification protocol combined to cell phenotypic screening, we identified a new toxin of 7329.38 Da (actiflagelin) that activates sperm motility in vitro from OF1 male mice. Actiflagelin is 63 amino acids in length and contains five disulfide bridges along the proposed pattern of disulfide connectivity C1-C5, C2-C3, C4- C6, C7-C8 and C9-C10. Modeling of its structure suggests that it belongs to the family of three finger toxins with a noticeable homology with bucandin, a peptide from Bungarus candidus venom. Conclusions This report demonstrates the feasibility of identifying profertility compounds that may be of therapeutic potential for infertility cases where motility is an issue.

Effect of incubating egg exposure to magnetic field on the biophysical blood properties of newly-hatched chicks

Due to widespread of human exposure to electromagnetic fields, there has been increasing public concern about the potential health risks from low-frequency electromagnetic fields; ELF-EMF. The magnetic fields [MFs] affects functions of the living organisms, such as DNA synthesis and ion transportation through the cell membranes. In the present work, the effects of short-term exposure to magnetic fields [MFs] prior to incubation were investigated on the ancliaysical blood properties of chicks hatched from layer-type breeder eggs. The eggs were exposed to a MF of 0.75mT at 50 Hz for 20, 40 and 60min before incubation. This study was performed by measuring the dielectric relaxation of hemoglobin [Hb] molecules and the membrane solubility of red blood cells [RBCs] using the non-ionic detergent octylglucoside. Exposure of the eggs to a MF increased the conductivity of the Hb molecules. The pronounced increase is the conductivity of the exposed eggs might be attributed to an increase in the surface charge of the Hb macromolecules, resulted from the formation of highly active molecular species. This speculation can be supported link increase in the relaxation time of the exposed groups. The solubilization process of the RBC membrane indicates a lass in the mobility of RBCs in the blood of hatching chicks

Development and evaluation of a medical communication scale

To evaluate the degree of communication with patients and their relatives based on a predesigned medical communication scale. A Prospective random sample assessment study. Intensive Care Unit, King Hamad University Hospital. We studied the scale randomly in 50 adult patients admitted to ICU. The degree of communication with the patient's next of kin was assessed by a native English speaking intensivist according to a scale designed for the purpose. Twenty-three [46%] relatives required the help of an interpreter for communication [class 4]. Full communication was possible with 15 [30%] relatives [class 2]. Twelve [24%] relatives did not have a full grasp of the working language or were informed to a below average level or were unwilling or uninterested in obtaining further knowledge. There was no relative with whom communication was impossible [class 5] nor was there any well-informed relative with whom communication was fully fluent [class 1]. The medical communication scale can help the physician to objectively quantify the ease or difficulty in communication with the patient's relatives. In the ethnically mixed workforce of our hospital, while the physician could fully communicate with many relatives, a significant percentage of the relatives were not proficient in the working language of the hospital and required the help of an interpreter to communicate with the physician

Children with isolated growth hormone deficiency: Empty sella versus normal sella.

BACKGROUND: Empty sella (ES) may be associated with variable clinical conditions ranging from the occasional discovery of a clinically asymptomatic pouch within the sella turcica to severe intracranial hypertension and rhinorrhea. The need for replacement hormone therapy in ES, as in other syndromes that may cause hypopituitarism, must be assessed for every single hormone, including growth hormone (GH). AIM: To determine whether or not the presence of ES could allow some changes in the GH responses of the isolated growth hormone deficiency (GHD) patients. MATERIALS AND METHODS: We included a cohort of 59 short stature children and adolescents with isolated GHD. According to computed tomography finding, they were classified into 2 groups: Group 1 included 40 children with normal sella and 19 children with ES in Group 2. All patients received recombinant human growth hormone (rhGH) with a standard dose of 20 IU/m2/week. RESULTS: The baseline results were not significantly different for all variables except weight standard deviation was smaller with statistical significant difference (P = 0.02). We identified no significant differences when comparing both groups, except for height standard deviation (HTSD) after the first year of therapy which revealed significant difference in favor of group 1. When comparing pre- and the two post-treatments HTSD results of the studied cases, all showed significant changes after GH therapy. The results of related variables pre-and post-treatment in both the groups showed significant improvement in all variables of the two groups of the study. CONCLUSION: Our study showed a similar stature outcome in the two treatment groups.

Growth response of Egyptian children with idiopathic short stature during four years of growth hormone therapy.

BACKGROUND: Multiple factors affect the growth response to recombinant human growth hormone (rhGH) in children with idiopathic short stature (ISS). AIM: To evaluate the growth responses of children with ISS treated with rhGH, aiming to identify the predictors of growth response. MATERIALS AND METHODS: We studied 120 cases, 90 males (75%), with a mean age of 13.8±2.7 years and 30 females (25%), with a mean age of 12.3±2.5 years. All patients received rhGH with a standard dose of 20 IU/m2/week. The calculated dose per week was divided into six days and given subcutaneous at night. RESULTS: A significant positive trend was detected in the delta changes of all anthropometric data. For the first year, the growth response was positively correlated to CA and BA delay and negatively correlated to height, weight and IGF-1 SDSs. For the second year, the growth response was correlated positively to first year growth velocity, BA, triceps skin fold thickness SDS and deviation from target height, and negatively correlated to weight, IGFBP3 SDS and target height SDS. For the third year, the growth response was positively correlated to five variables namely target height, 2nd year growth velocity, IGF-1 SDS, weight SDS and triceps skin fold thickness SDS. For the fourth year, growth response was positively correlated to 2nd and 3rd year growth velocity, BA, deviation from target height and weight/ height SDS. CONCLUSION: Our study showed multiplicity of predictors that is responsible for response in ISS children treated with rhGH, and BA was an important predictor.

Improvement of liver functional status in diabetic conditions by fresh wheat germ [golden green] supplementation in human patients

Fresh wheat germ [Golden Green] was examined for its possible hypoglycemic and hypocholesterolemicinfluences in human patients with several hep1tic complications. A period of four weeks of dietary regimen containing fresh wheat germ flakes [30g daily] was found to be remarkably beneficial, as indicated by significant reduction of serum glucose and lipid profile in diabetic patients. This was also accompanied by slight decrease in patient body weights. Dietary fresh wheat germ feeding also significantly countered other metabolic alterations as revealed by lowering blood urea, creatinine in all patient groups. Obtained results indicated also that incorporation of fresh wheat germ together with the daily nutritional pattern was not changed the daily food intake by all of examined four human groups. All of elevated liver enzymes [ALT, AST and ALP] in diabetic patients with liver complications were significantly lowered. Serum minerals [Fe, Ca, P, Zn and I], hemoglobin, hematocrit, ferritin and detoxifying enzymes [glutathione, catalase, glutathione-S-transferase and glutathione reductase] were significantly [P< 0.05] increased at the end of supplementation course of fresh wheat germ

Bone age is the best predictor of growth response to recombinant human growth hormone in Turner’s syndrome.

BACKGROUND AND OBJECTIVES: Recombinant human growth hormone (rhGH) is approved for use in children with Turner’s syndrome (TS) in most industrialized countries and is recommended in the recently issued guidelines. We determined the growth responses of girls who are treated with rhGH for TS, with an aim to identify the predictors of growth response. MATERIALS AND METHODS: Fifty-six prepubertal girls with TS, documented by peripheral blood karyotype, were enrolled. All the patients received biosynthetic growth hormone therapy with a standard dose of 30 IU/m2/week. The calculated dose per week was divided for 6 days and given subcutaneously at night. RESULTS: This study showed that rhGH therapy provides satisfactory auxological results. Bone age delay is to be considered as a predictive factor which may negatively influence the effect of rhGH therapy on final height. The growth velocity in the preceding year is the most important predictor of rhGH therapy response. CONCLUSION: These observations help us to guide rhGH prescription, to reduce the risks and costs.

Anatomical study of the arterial supply of the superior and inferior lips

The perioral region, being a site for many surgical reconstructive flaps, has become a target for many researches. The aim of the present study was to investigate the arterial supply of both upper and lower lips to provide an anatomical basis for alternatives of reconstruction methods in the perioral region. Forty two cadaveric face sides [21 preserved adult human cadavers] and 8 fresh face sides [4 stillbirths] were dissected after injection of the common carotid arteries with red latex. The facial artery and its branches, supplying both lips were dissected. The origin, course, branches, length, external diameter at their origin and anastomosis of both superior [SLA] and inferior [ILA] labial arteries were studied. The upper lip was constantly supplied by the SLA supplemented by an additional branch from the facial artery in only 10% of specimens. According to the mode of origin of the SLA, four patterns were observed. In type A [66%] the SLA was a side branch from the facial artery, type B [12%], it originated from the lateral nasal artery. It was one of the two terminal branches of the facial artery with either the ILA [type C, 12%], or the lateral nasal artery [type D, 10%]. The level of origin of the SLA was either above [72%], at [16%] or below [12%] the level of labial commissure. The mean distance between the origin of SLA and the labial commissure was 17.59 mm. The mean external diameter of the SLA at its origin was 1.69 mm. Its mean length was 52.19 mm. In 88% of specimens the SLA gave septal and anastomotic branches, while in 12% of specimens the septal branch originated from the facial artery above the origin of the SLA. The lower lip was supplied by the ILA in all specimens. Supernumerary branch from the facial artery proved to participate in the supply in 12% of specimens. The mean distance between the origin of ILA and the labial commissure was 27.5 mm while that for its external diameter at its origin was 1.86 mm. Its mean length was 60.81 mm. Both the SLA and the ILA coursed deep to the orbicularis oris muscle. The present results proved the great potentials for perioral flaps based on SLA or ILA. The vessels are long enough for rotation flaps. They can provide full thickness flap as they supply the entire thickness from skin to mucosa. They have a diameter large enough to allow microsurgical anastomosis. Free anastomosis between the labial arteries across the midline insures adequate nourishment of the donor lip

Emergency ureteroscopic management of acute calcular anuria

To study the outcome and complications of emergency ureteroscopy in management of acute calcular anuria. 35 patients with calcular anuria were included in the study. The mean age was 45 +/- 18 years with 30 male and 5 females. The diagnosis was based upon anuria associated with high serum creatinine and hydronephrosis detected by ultrasonography. KUB was done to detect radio-opaque stones and its location and size. Emergency ureteroscopy was done to all cases. Bilateral ureteric calculi were detected in 31 patients and unilateral ureteric calculus in 4 patients in whom the other kidney was surgically removed. The stones were localized in the distal ureter in 50 units and in the proximal ureter in 16 units. 60 stones were radio-opaque and 6 stones were radiolucent. The mean stone size was 9 +/- 3mm. The mean serum creatinine was 7.3 +/- 2.5 mg/100 ml. The stone free rate in the proximal ureteric stones was 50% and for the distal ureteric stones was 90%. The overall stone free rate was 80%. No complications were discovered after ureteroscopy to any case. The urine output increased dramatically immediately after treatment in all cases. The serum creatinine dropped to the normal level in all cases [1.2 +/- 0.4 mg/100 ml] in 6.9 +/- 1.8 days after treatment. The mean hospital stay was 2.8 +/- 1.3 days. Emergency ureteroscopy is a safe and an appropriate therapeutic option in the management of acute calcular anuria. It can save patients from a second procedure

role of varicocelectomy on seminal plasma soluble Fas as a marker of Fas-mediated apoptosis of testicular germ cell in infertile men with varicocele

This prospective study was designed to estimate seminal plasma [SP] levels of soluble Fas [sFas] in infertile men with varicocele as a trial to evaluate the role imposed by apoptosis on the outcome of varicocelectomy in terms of seminal parameters. The study comprised 40 subfertile patients with varicocele and 10 fertile men as controls. All men were evaluated clinically for varicocele grading and determination of testicular dimensions. Patients were assigned to undergo bilateral varicocelectomy by subinguinal approach with arterial and lymphatic sparing procedure. Semen samples were divided into two parts for routine semen analysis and estimation of SP sFas; prior to and 4 months after surgery. There were 23 patients with grade I, 10 with grade II and 7 with grade III varicocele. There were 15 patients with hypotrophic testes; 5 bilateral and 10 had left hypotrophic testes. Postoperative seminal parameters showed significant improvement in comparison to preoperative ones, but were still significantly different compared to control levels. Mean preoperative SP sFas concentration was 3.12 +/- 1.14 ng/ml, whereas in controls it was 5.42 +/- 1.74 with a significant decrease of patients concentration. Mean SP sFas concentration in oligospermic patients was 2.62 +/- 1.11, while in non-oligospermic patients was 3.36 +/- 1.08 with a significant decrease in oligospermic compared to non-oligospermic concentrations. Mean SP sFas levels in patients was inversely correlated with the varicocele grade and a positive significant correlation with sperm concentration. Postoperative SP sFas showed a significant increase in patients compared to their preoperative levels, but still significantly lower compared to control levels. The SP sFas increased in oligospermic patients more than in non-oligospermic patients. It could be concluded that varicocele could reduce male fertility via induction of Fas-mediated apoptosis of germ cells and this effect could be ameliorated by varicocelectomy with a more beneficial results in patients with oligospermia

Comparison of Surgically Induced Astigmatisms after Clear Corneal Incisions of Different Sizes

PURPOSE: This study was performed to assess efficiency and stability of astigmatic change by incision size after cataract surgery. METHODS: This work was designed as a retrospective, comparative, nonrandomized interventional study. A total of 121 cases of cataract surgery were reviewed in 98 patients performed by one surgeon at the Oregon Eye Institute in Eugene, OR, USA with 3-year follow-ups. All procedures were performed with the temporal approach of self-sealing incisions. The serial change in surgically induced astigmatisms were examined in all cases of three groups: Group A, cartridge injection of a foldable IOL through a 2.5 mm self-sealing incision; Group B, cartridge injection of a foldable IOL through a 3.0 mm self-sealing incision; Group C, cartridge injection of a foldable IOL through a 3.5 mm self-sealing incision. Keratometric data were obtained preoperatively, and 3 weeks, 3 months, 6 months, 9 months, 12 months, 24 months and 36 months postoperatively. Polar value analysis was performed to calculate the surgically induced astigmatism. RESULTS: The astigmatic change decreased over time in Group B (P<0.05). The other groups tended to remain in induced astigmatism. All groups showed anticlockwise torque at 3 weeks following surgery. Group B showed a decrease in deviation, but the other groups showed increases in their torque value at postoperative 12 months (P<0.05). CONCLUSIONS: The 3.0 mm incision size correlated with the least surgically induced astigmatism.

comparison of laryngeal mask airway [LMA [TM]] and peilaryngeal airway cobra [C PLA [TM]] in mechancally ventilated anaesthetised pediatrics

The laryngeal mask airway is [LMA[TM]] is a frequently used efficient airway device, yet it sometime seals poorly thus reducing the efficacy of positive -pressure ventilation. The Cobra perilaryngeal airway [CPLA [TM]] is a new supraglottic device which consists of a tube and inflatable cuff. The present study compared the LMA[TM] and CPLA[TM] in mechanically ventilated anaesthetized pediatrics. This study was carried out in 46 pediatric patients age range between 6 months and 2 years scheduled for elective surgery, they were divided into 2 group 23 patients each, group I CPLA[TM], Group II LMA[TM] both were inserted after fentanyl, propofol and vecuronium, Mean time of insertion, number of attempts of insertion and repositioning, airway sealing pressure, adequacy of the airway and side effects was recorded. There was no statistically significant differences between groups as regard the mean time of insertion, number of attempts of insertion and repositioning and adequacy of the airway [no leak at 15 cm water peak pressure]. There was statistically significant higher airway sealing pressure in the CPLA[TM] group and higher incidence of sore throat when compared to LMA[TM] group. Cobra Perilaryngeal Airway [CPLA[TM]] is as efficient as the Laryngeal Mask Airway[LMA[TM]] but with better air way sealing pressure and higher incidence of sore throat in mechanically ventilated anaesthestised pediatrics

Evaluation of low intensity gallium arsenide diode laser influence on the healing of the oral mucosaltissue wounds of induced diabetes

This study was performed to evaluate and compare the effect of Gallium Arsenide diode laser [Ga-As laser] as an adjunct to wound healing in experimental induced diabetes in rats. It was conducted on sixty adult albino rats, all animals had undergone excising small biopsy of the oral mucosa, and then thirty rats were subjected to low intensity laser therapy while the remaining thirty rats were used as diabetic control. Animals were sacrificed after one week and two weeks intervals and specimens were collected for microscopic as well as immunohistochemical evaluation. The correlation between different methods of assessment assured the findings of this study that laser treated animals showed accelerated healing compared to non-lased animals

Assessment of the healing activity of oral mucosal tissues of irradiated rats receiving vitamin C following a new modality of CO[2] laser therapy

Eighty [80] male albino rats were included in this study. The rats were divided into two groups. The first group [40 rats] subjected to scalpel surgery to excise a biopsy about 2 x 2 mm from the lower anterior labial vestibule. The second group [40 rats] received CO[2] laser in the same way at 6 watts in a focused mode with water irrigation. Ten animals from each group were sacrificed at weekly intervals from the date of beginning of surgery for 3 weeks. The biopsies were assessed histopathologically and immunohistochemically. The results were confirmed by the image analysis and statistical analysis. It has been found that CO[2] laser could be considered as an excellent surgical instrument and become an alternative modality in performing many of surgical procedures