Epidemiological survey of dermatophytosis in Damascus, Syria, from 2008 to 2016.

BACKGROUND AND PURPOSE: It is important to follow annually the probable changes in distribution pattern of dermatophytosis and its etiological agents in different communities. In this study, we determined the prevalence of dermatophytosis and its causative agents in Damascus, Syria, between 2008 and 2016. MATERIALS AND METHODS: A total of 4080 outpatients who visited the dermatological clinics in Damascus, were evaluated. The specimens were collected from clinically suspected tinea. The patients were referred to our laboratory for direct examination by 30 %KOH. Some of the specimens were cultured on Sabouraud Dextrose Agar for fungal identification. RESULTS: Out of the 4080 cases, 1138 cases were positive in direct examination(%27.89) , including Tinea pedis (%46.98), followed by tinea capitis(%39.79) , tinea corporis (%25.38), toenail onychomycosi (%20.33), tinea manuum (%16.06), and fingernail onychomycosis .(%15.22) Tinea pedis and toenail onychomycosis were more common in summer %41.19) and %25.78 respectively .(Trichophytic rubrum was the most prevalent fungal pathogen, especially in toenail onychomycosis. CONCLUSION: Dermatophytosis is highly prevalent in Syria. This study provides valuable data for differential diagnosis of dermatophytosis.

Are sperm motion parameters influenced by varicocele ligation?

OBJECTIVE: To document objectively, improvements in sperm motion parameters in subfertile men after varicocele ligation with the use of computer-aided sperm analysis. DESIGN: Retrospective chart review. SETTING: An academic clinical environment. PATIENT(S): Thirty-four men with varicocele as the primary cause of infertility who underwent a physical examination, hormonal profile, and Doppler ultrasound evaluation. INTERVENTION(S): Computer-aided sperm analysis was performed before and after either subinguinal or laparoscopic varicocele ligation. MAIN OUTCOME MEASURE(S): Patients were followed up for 3-18 months after operation, and average computer-aided sperm analysis values were obtained before and after operation. Computer-aided sperm analysis values were analyzed by paired Student's t-test, with special reference to motility and sperm motion parameters. RESULT(S): After varicocele ligation, patients demonstrated increases in mean sperm density and in the overall distribution of sperm with rapid velocity, although the increases were not statistically significant. Mean measures of straightness, linearity, and track speed also were increased after operation, but only progressive sperm velocity was increased to a statistically significant level. CONCLUSION(S): Because progressive velocity has been a primary computer-aided sperm analysis parameter predictive of male fertility and the success of assisted reproductive techniques, we conclude that varicocele ligation results in improvements in semen parameters, especially the key parameter of progressive sperm velocity.

A prospective study of a monophasic oral contraceptive containing 30 mcg ethinyl oestradiol and 150 mcg desogestrel (Marvelon).

PIP: Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.^ieng

[Study of phlebotomus sandflies in Syria]. / Contribution à l'étude des phlébotomes de Syrie.

An entomological survey was carried out during 1986 in ten provinces of Syria representative of the main natural areas of this country. 932 sandflies were caught with aspirators in domestic resting sites. Captures are analysed for each species.

A randomised comparative study of Triquilar versus Marvelon: the Malaysian experience.

PIP: Health workers in Malaysia randomly assigned either a low-dose triphasic or a low-dose monophasic oral contraceptive (Triquilar and Marvelon, respectively) to 198 women to examine discontinuation rates and reasons for discontinuation. 15.3% of Triquilar women and 9.1% of Marvelon women forgot to take 1 pill at some time during the study while 6.1% and 3% forgot to take at least 3 consecutive pills. There were more complaints and/or complications among Triquilar women than among Marvelon women. The most serious complication was severe headaches (only 1 woman from each group). 2 women in the Marvelon group complained of either generalized itchiness or digestion impairment. Complaints of women in the Triquilar group included localized and generalized itchiness, weight gain, digestion impairment, dryness of vagina, and numbness of extremities. Women in the Triquilar group were more likely to have menstrual complaints than those in the Marvelon group (14.3% vs. 9.1%). The leading menstrual complaint in both groups was spotting (6.1% vs. 4%). No Marvelon women reported menorrhagia, scanty menses, or intermenstrual pelvic pain or discomfort while at least 1 woman did from the Triquilar group. The percentage of women with changes in complaints since admission were the same for both groups. Total discontinuation rates which included lost to follow ups were 46.9% and 40%, respectively. The most common reason for discontinuation for both groups was desired method change (11.2% Triquilar and 14.1% Marvelon). Method unrelated reasons (unable to return to clinic, moving/travel, and not interested in the study) were the next most common reason for discontinuation. 3 women conceived while taking Triquilar. These pregnancies were attributed to method failure, perhaps due to incomplete pituitary suppression. There were no accidental pregnancies in the Marvelon group.^ieng

A study of the acceptability and effectiveness of Norplant (R) contraceptive implants in Kuala Lumpur, Malaysia.

PIP: A clinical trial was carried out on the levonorgestrel-containing subdermal contraceptive implant to evaluate its efficacy and acceptability among Malaysian women. The study recruited 121 women in and around the Kuala Lumpur Federal Territory over a 13-month period (March 1986-March 19870 and followed regularly for 2 years at intervals of 3, 6, 12, and 24 months. The acceptors consisted of 53.7% Malays, 24.8% Indians, and 21.5% Chinese. 81% of the selected females were between 20-34 years in age (mean=30). The average parity was 3.9 children; 81.8% reported that they did not want to have a child in the he next 3 years. In the last 6 months, 45.5% of the study group had used the oral contraceptive pills, 15.7% had used the intrauterine contraceptive device, and 17.4% had not employed any method. The results showed that the subdermal implant Norplant (R) is effective and safe. The gross cumulative continuation rate was 93.8 at 6 months, 88.2 at 12 months, and 72.2 at 24 months. Within the 24 month period, 26 terminations occurred as a result of pregnancy (n=1), menstrual problems (n=9), medical reasons (n=12), and personal reasons (n=4). the gross cumulative termination rate/100 women for pregnancy was 0 at 12 months and 1.7 at 24 months. Major side effects include menstrual problems, weight gain, dizziness, and headache. After 1 year, 13.3% of the cases (n=2) had the implant removed. The acceptability of the method among our women in 4 clinics around Kuala Lumpur and other Norplant (R) studies in other countries is comparable to the intrauterine devices among Malaysian women; the termination rate for accidental pregnancy is lower than that of IUD. The device is easy to administer in a small clinical set-up though it requires personnel specially trained in the surgical techniques; 86.0% of the acceptors reported complication-free insertion. This may be a method to be introduced to our National Family Planning Program in our efforts to offer a wider range of safe and effective methods of family planning. (author's modified).^ieng

Filshie clip sterilization -- single puncture laparoscopic approach (a preliminary report).

PIP: In 1986, single puncture laparoscopic application of the Filshie clip was introduced into Malaysia's National Population and Family Development Board's female sterilization program for an evaluation. A total of 42 female sterilizations were performed by this method between June 1986 and December 1986. Laparoscopy was performed on an outpatient basis under local anesthesia. In 37 cases, the sterilization was interval. Filshie clips were successfully applied to the fallopian tubes of 40 women; in the remaining 2 cases, the latching mechanism jammed and Falope rings were used instead. The average time from application of 1st clip to skin closure was 10 minutes. During clip application, technical problems (faulty applicator, clip fell into the pelvic cavity, failure of latching mechanism) were encountered in 4 cases and surgical difficulties (poor visualization, hydrosalpinx, and tubal adhesions) occurred in 10 cases. In general, complications were minimal: 1 patient developed cynosis after anesyhesia (Pethidine) injection, the omentum was torn during introduction of the trocar in another, and a 3rd patient developed thrombophlebitis at the intravenous site. Only 1 pregnancy was recorded during the follow-up period; this occurred 15 months postoperatively and was intrauterine. Given the facts that this procedure is easy to learn, fast and simple, associated with no more complications than other laparoscopic procedures, and is cosmetically more acceptable to women, its more widespread application is recommended.^ieng

A prospective study of the acceptability of Today vaginal contraceptive sponge among Malaysian women.

PIP: In a 2 month study to test the viability of vaginal sponges for use among Malaysian women 50 cases were followed. Of the 50 cases 1 developed an allergic reaction, 49 participated in a 1-month checkup after which 13 stopped for various reasons not related to the use of the sponge. The other 36 completed the study in which there were few side effects and many of the women said sexual intercourse was less messy. The 50 subjects were 18-45 years of age, healthy with no vaginal infection, irritation, inflammation and pregnancy, and had to be sexually active. All but 1 of the cases had been pregnant before and the majority of the group had sexual intercourse twice a week. Only 3 cases had problems in the initial insertion and removal of the sponge. 2 cases reported non use at some time, but the majority retained the sponge from 6-24 hours. Of those who discontinued use, 3 migrated to other areas, 6 had husbands who did not like it, 1 had vaginal cramps, 1 unplanned pregnancy, and 1 had a planned pregnancy. Of the remaining 36 there where 4 who lacked confidence in the effectiveness of the sponge. The general conclusion of the study is that the sponge is an acceptable, safe, convenient, inexpensive, and does not cause discomfort to those using it. Its longterm use as a reliable contraceptive device should be verified.^ieng

[Septicemias caused by Candida and other yeasts. Study of cases observed for 5 years at the University Hospital Center in Strasbourg]. / Les septicémies à Candida et autres levures. Etude des cas observés en 5 ans au CHU de Strasbourg.

Seventy one files of patients with yeasts septicemia have been studied. This study indicates the influence of factors like age (greater than 50 years), health condition, surgery mainly digestive, severe associated bacterial infections, iatrogenic factors (polyantibiotherapy, catheters, intubation), in the occurrence of these septicemia). Clinical symptoms appear to be mainly fever (93%) accompanied with shudders (26%) and toxi-infectious shock (45%). Diagnosis is made by the isolation of yeasts from the blood cultivated on Sabouraud-Chloramphenicol diphasic medium. Among the responsible yeasts, the genus Candida is predominant (82.2%) with C. albicans (59%) followed by the genera Torulopsis (13.7%) and Trichosporon (2.7%). Medical treatment must associate Amphotericin B and 5 Fluorocytosine.

Sex pheromones inCulicoides nubeculosus (diptera, ceratopogonidae): Possible sites of production and emission.

This study was performed on virgin females ofCulicoides nubeculosus to determine sites of production and emission of sex pheromone. The ventral abdominal surface is the site of emission of the pheromone. Morphologically there is evidence of the presence of abdominal atrichial areas. The abdominal areas, eight per segment (four ventral and four dorsal), are covered by a cuticle devoid of micro- and macrotrichiae. The dorsal and ventral areas differ considerably in their structure. The dorsal atrichial areas have an unperforated cuticle covering a normal epidermis, whereas the ventral atrichial areas have a cuticle perforated by numerous tubular structures, with a loosely organized procuticle and no underlying epidermal cells. A pair of voluminous cells with the classical ultrastructural characteristics of enocytes is invariably located in the vicinity of the ventral atrichial areas. These cells undergo ultrastructural modifications tending towards involution according to the age of the insects, being correlated with the decrease in pheromone emission by older females. The hypothesis is put forward that enocytes are involved in pheromone production.

[The sexual activity of Culicoides nubeculosus (Mg.) (Diptera, Ceratopogonidae) (author's transl)]. / Etude sur l'activité sexuelle de Culicoides nubeculosus (Mg.) (Diptera - Ceratopogonidae).

The sexual activity of C. nubeculosus has been studied in relation to the age of males and females. The criteria chosen were stoutness of spermatheca and frequency of mating, respectively. A unit N. M. H. (number of matings/male/hour) has been determined. Sexual activity reaches its maximum on 2nd day of imaginal life and is then slowly decreasing. This maximum activity on 2nd day rapidly decreases in the hours following blood meal, down to a rate which then remains nearly constant.

[Effect of blood meal on the secretion of pheromone by females of C. nubeculosus (Diptera, Ceratopogonidae) (author's transl)]. / L'effet du repas sanguin sur la production de phéromone par les femelles de C. nubeculosus (Diptera, Ceratopogonidae).

In a previous study, we showed that virgin females of C. nubeculosus secrete a sex pheromone which attracts males of the same species and stimulates mating. We consider that a number of physiological factors may be capable of modifying this secretion. In this study, we have investigated the effect of a blood meal on secretion of the pheromone by virgin females. No change in secretion of the pheromone was observed during the blood meal, but a decrease was evident during the next few hours. This decrease continues up to 24 hours after the blood meal, by which time oogenesis has started. At 48 hours after the blood meal, when the eggs are mature, secretion of the pheromone increases. An even more pronounced increase is observed during the period of oviposition, occurring 3 to 4 days after the blood meal. Secretion of the pheromone subsequently diminishes.