Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from 2003-2007 ...Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from 2003-2007 at Government maternity hospital, Osmania medical college, Hyderabad, 666 women with eclampsia and imminent eclampsia were managed. The number of eclampsia and imminent eclampsia (IE) was 532 and 134, respectively. We have analyzed the clinical profile, parity, age, degree of proteinuria, the period of gestation in weeks, the antenatal care, the number of antenatal visits, referrals from other hospitals, the diastolic B.P. at the time of admission, the recurrence of convulsions and the complications. 1) All the cases of eclampsia and IE were managed with magnesium sulphate as an anticonvulsant. 2) Oral nifedipine, IV labetalol, sublingual nifedipine and nitroglycerine infusion were used to control severe hypertension. 3) Prostaglandin E1 (PGE1) was used for induction of labour (IOL), 25 mcg × 4th hrly, vaginal route and 50 mcg for less than 28 weeks gestation, in 290/424 cases of IOL. Other methods of IOL were employed in 134 cases. Results: Eclampsia (n = 532) occurred antepartum in 407 (75.56%), intrapartum in 76 (14.28%), post partum in 46 (8.64%) and intercurrent in 3 (0.5%) patients. The period of gestation was 34 weeks in 340 patients. Induction of labour with misoprostol was done in 290 with vaginal delivery in 235 (81%) and lower segment caesarean section (LSCS) for failed IOL in 55 (19%) and other methods of IOL were used in 134. The total number of deliveries was 656, with vaginal deliveries in 336 (66.46%) patients, ceasarean deliveries in 220 (33.54%) patients. Ten patients died undelivered. Maternal mortality was 17/666—2.55%. Cerebrovascular events were responsible in 13/17 (76.46%) patients, pulmonary embolisim in 2, aspiration pneumonia in one and sepsis in one. The perinatal mortality was 167/582 (28.69%), PNM when birth weight was >1.5 kg was 59/426 (13.84%), intrauterine fetal deaths at admission were 54 (8.5%), there were four sets of twins. Conclusions: 1) More effective measures to control hypertension and routine administration of anticonvulsant, magnesium sulphate to women with eclampsia should be practised from the first referral unit itself. 2) Our caesarean delivery rate of 33.54% in the very high risk cases of eclampsia and imminent eclampsia is very low compared to others. 3) Induction of labour with misoprostol was successful in 81% with consequent reduction in caesarean section rate and morbidity and mortality associated with caesarean deliveries. Misoprostol has proved to be a safe and effective inducing agent in eclampsia. 4) The maternal mortality in our series is 2.55%.展开更多
Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Object...Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Objectives: This study aimed to find incidence, indications, procedures and maternal outcome of re-laparotomy after caesarean delivery. Methods: This was a descriptive cross sectional prospective total coverage hospital based study conducted at Omdurman Maternity Hospital from June 2014 to January 2015. Results: The incidence for re-laparotomy after Caesarean section is (0.66%) and the main indication for re-laparotomy is hemorrhagic events. Re-laparotomy outcome reported 22 cases (64.7%) alive and well and 6 cases (17.6%) alive with morbidity (renal failure and massive blood transfusion complications) and 6 cases (17.6%) of maternal mortality mainly due to sepsis. Conclusion: Re-laparotomy after Caesarean section is contributing to morbidity and maternal mortality. The majority of re-laparotomy was done after emergency Caesarean section. Lacks of skills, experience;safety measures of perfection and infection control are points to be concern.展开更多
Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during ...Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months;and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.展开更多
Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortali...Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortality associated with maternal diabetes at the Issaka Gazoby Maternity Hospital in Niamey. Methodology: This was a prospective case-control study conducted from April to September 2021 at the Issaka Gazoby Maternity Hospital in Niamey. “Cases” were neonates born to diabetic mothers, and “controls” were neonates born to non-diabetic mothers. The main dependent variable was the occurrence of perinatal complications. Analysis was performed using Epi info software 7.2.1. Pearson’s Chi2 test or Fisher’s exact test were used (p Results: Of the 2,225 admissions during the study period, 31 newborns were born to diabetic mothers (1.4%). Diabetic mothers were 2.8 times more likely to have a history of abortion (67.7% vs. 28.6%;OR = 2.82;p = 0.001). Similarly, a history of macrosomia was found in 29.0% of diabetic mothers versus 9.5% of controls (OR = 2.15;p = 0.01). Macrosomia was also more common in newborns of diabetic mothers (38.7% vs. 9.5%;OR = 2.63;p Conclusion: The risks of ante- and perinatal complications such as abortion, fetal macrosomia and stillbirth, as well as neonatal pathological events (macrosomia and malformations) were greater in newborns of diabetic mothers.展开更多
<strong><em>Backgrounds</em></strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> T...<strong><em>Backgrounds</em></strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Teenage pregnancies are generally considered as a high-risk however, sufficient data is lacking in the area, Cairo Egypt. We attempted to </span><span style="font-family:Verdana;">determine whether teenage pregnancies show poorer outcomes than adult-age </span><span style="font-family:Verdana;">pregnancies. </span><b><i><span style="font-family:Verdana;">Objectives</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> Finding out the prevalence of teenage pregnancy and its maternal and fetal outcome in comparison. </span><b><i><span style="font-family:Verdana;">Subjects</span></i> <i><span style="font-family:Verdana;">and</span></i> <i><span style="font-family:Verdana;">methods</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> A retrospective analytical case-control study was conducted on patients who had attended for delivery at Al-Galaa Maternity Teaching Hospital during the period of one year from March 2015 to February 2016. A total of included 538 patients aged 16 - 19 years as study group and adult age group: included 609 patients aged 25 - 29 years as the control group. The only primigravid was enrolled. The study records were retrieved for review. Comparisons were made between the two groups regarding maternal demographics, socioeconomic status, medical disorders, major antenatal complications, the outcome of labor, mode of delivery, and perinatal complications. </span><b><i><span style="font-family:Verdana;">Results</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> The prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered the significant prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered significant. Teenagers had a lower antenatal care attendance (63.8% vs 76.7%;P = 0.001), a higher incidence of Eclampsia (2.1% vs 0%;P = 0.000), vaginal deliveries (70.1% vs 51.9%;P = 0.000). And a higher maternal ICU admission (1.4% vs 0.0.7%), and maternal death (0.5% vs 0%),especially in low socioeconomic. On the other hand, the adult group pregnancies had a higher incidence of gestational hypertension, gestational diabetes, and cesarean delivery. </span><b><i><span style="font-family:Verdana;">Conclusions</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> Teenager primigravid women should be considered as a high-risk pregnancy and thus require special medical attention to avoid adverse maternal and neonatal outcomes.</span></span></span></span>展开更多
Procidentia is one of complications of pregnancy and childbirth. The challenge of treatment is to preserve fertility if needed and to find effective methods with rapid learning curve. Our technique—Isam technique—fu...Procidentia is one of complications of pregnancy and childbirth. The challenge of treatment is to preserve fertility if needed and to find effective methods with rapid learning curve. Our technique—Isam technique—fulfills these needs with a short hospital stay, very low risk of complications and relapse, a rapid learning curve as well, and no need for long contraceptive methods after operation.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on...Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on a large postpartum ovarian cyst in a 40-year-old patient. The diagnosis was suspected based on clinical and ultrasound signs and confirmed by exploratory laparotomy. The appearance of the cyst was suggestive of a mucinous cystadenoma of the ovary. The treatment was radical by performing an adnexectomy. The surgical piece weighed 5.2 kg. The postoperative course was simple. Anatomopathological examination had not been carried out;the parents had buried the operating piece.展开更多
Background: Maternity nurses are frontline health professionals in the COVID-19 pandemic who may confront life-altering challenges. Studies that evaluated the impact of COVID-19 on maternity nurses’ daily lifestyles ...Background: Maternity nurses are frontline health professionals in the COVID-19 pandemic who may confront life-altering challenges. Studies that evaluated the impact of COVID-19 on maternity nurses’ daily lifestyles are limited. Objective: The aim of this study was to examine the changes in health-enhancing behaviors, such as eating habits and lifestyle behaviors, during the COVID-19 pandemic among nurses working in a maternity hospital. Methods: This was a cross-sectional study that surveyed maternity nurses working in a major government maternity hospital in Kuwait. Data were collected between January and February 2021. Results: A total of 336 participants completed the questionnaire. Normal weight was perceived by 88 (26.2%) of the participants, while 56 (16.7%) had a Body Mass Index indicating obesity. Weight gain during the pandemic was reported by 128 (38.1%) participants and 91 (27.1%) of the sample gained one to three kilograms. The findings showed low adherence to the Mediterranean diet 5.3 ± 2.5 points. Sleep hours decreased significantly during the crisis, with 113 (33.6%) of participants sleeping 7 to 9 hours during the COVID-19 situation compared to 136 (40.5%) before the pandemic (p Conclusion: Maternity nurses revealed low adherence with the healthy diet, with almost a third of participants having self-reported weight gain. Further, the sleeping patterns and the practicing of physical activities were negatively affected by COVID-19 pandemic.展开更多
Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric...Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.展开更多
Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the ...Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.2%), an obstetric gynaecology resident (six patients, 2.5%), or a general practitioner with district surgical expertise (three patients, 1.3%). In the majority of cases (180 patients, 75.3%), total hysterectomy was performed. The incidence of maternal mortality (26 patients, 10.9%), and perinatal mortality (223 newborns, 93.4%) was notably elevated in our series. Conclusion: Our findings are in close alignment with those previously documented in the literature. The practice of emergency obstetric hysterectomy is a common occurrence in our region. It is considered a last resort when conservative procedures have failed or are not an option. Improved obstetric management would result in a reduction in the number of cases of haemostatic hysterectomy. The availability of blood products is expected to improve maternal prognosis.展开更多
Objective: to analyze the channels, problems and positions of pediatric complaints in a secondary maternal and child health care hospital in Beijing, so as to formulate corresponding preventive measures. Methods: the ...Objective: to analyze the channels, problems and positions of pediatric complaints in a secondary maternal and child health care hospital in Beijing, so as to formulate corresponding preventive measures. Methods: the data of 48 complaints of pediatrics in our hospital from January 2018 to October 2021 were analyzed retrospectively, and the total number of complaints, complaint channels, complaint problems and complaint posts were compared respectively. Results: in 48 cases, the main channel of complaint was 12345 citizen hotline, accounting for 48.0% (23/48);The main complaints were medical quality, accounting for 27.1% (13/48);The main complaint posts were general outpatient service, accounting for 66.7% (32/48). Conclusion: the hospital should strengthen the training, improve the humanistic care quality and doctor-patient communication ability of doctors, and improve the complaint management system, so as to formulate corresponding preventive measures and reduce the incidence of complaints.展开更多
Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of t...Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.展开更多
AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent ...AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) testing.The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ criteria.RESULTS:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD group.The FH group included 22 patients with no reflux involvement.Sex, age, and body mass index did not differ significantly between the groups.The mean SF-36 values were < 50(normal) for all scales in these groups, with no significant differences.The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms.The QUEST and the FSSG scores did not differ significantly between the groups.Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant differences.CONCLUSION:Clinical characteristics of the FH and PPI-refractory ENRD groups were similar.Therefore,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them.展开更多
OBJECTIVE： Elevated natural killer lymphocyte cytotoxicity（NKc） has been linked with reproductive problems in women. Here we evaluate the potential benefit of cupping therapy（CT） in reproductionrelated immune res...OBJECTIVE： Elevated natural killer lymphocyte cytotoxicity（NKc） has been linked with reproductive problems in women. Here we evaluate the potential benefit of cupping therapy（CT） in reproductionrelated immune responses.METHODS： This was a pilot clinical study. Participants were he althy fe male volunteers（n = 23） with elevated NKc, and received repeated CT 3 times over 5 d（inner pressure 40–50 kPa, 40 min; 12–1 5 cups）. Lymphocyte subsets, NKc and NK lymphocyte activity（NKa） were measured in blood on day 0（initial levels, before the first treatment） and days 3, 10 and 17 after the last CT treatment, using the K562-stimulated CD69 expression assay.RESULTS： As a result of CT manipulations NKa was reduced on days 3 and 10, and NK percentage was reduced on day 10. NKc was most sensitive to CT treatment, resulting in their decreased counts at 3, 10 and 17 d post CT. CT treatment decreased NKc in the majority of individuals（87%）, but the magnitude of the effect was variable. Out of 23 subjects 9（39.1%） had a 2–3 fold decrease of NKc on days 3, 10 and 17; 11（47.8%） started to show a decrease in NKc later, or more quickly returned to base levels; and only 3（13%） subjects displayed no effect of CT on NKc. Expectedly, no changes in T-cell subsets（CD3CD4, CD3CD8, HLADR, CD158a） were observed after CT.CONCLUSION： CT decreased NK cell numbers, their activity and cytotoxicity. Low cost, safety, noninvasive nature and ease of administration make CT a promising approach for NKc down-regulation.展开更多
The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etio...The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.展开更多
Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that a...Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that are available and the success rates of these treatments have not been investigated in depth. The medical records of 682 patients who cryopreserved sperm cells due to cancer treatment were analyzed. Seventy of these patients withdrew their frozen sperm for fertility treatments over a 20-year period （most within the first 4 years after cryopreservation）. Sperm quality of different malignancies and outcomes of assisted reproduction treatment （ART） for pregnancy achievement in relation to the type of treatment and the type of malignancy were evaluated. The results showed that the rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10.3%. Sperm quality indices differed between different types of malignancies, with the poorest quality measured in testicular cancer. Conception was achieved in 46 of the 184 ART cycles （25%）, and resulted in 36 deliveries. The use of intracytoplasmic sperm injection （ICSI） methodology yielded a significantly higher pregnancy rate （37.4%） than intrauterine insemination （IUI; 11.5%） and was similar to other groups of infertile couples using these modalities. In vitro fertilization （IVF） failed to produce pregnancies. In conclusion, the rate of use of cryopresseved sperm in cancer patients is relatively low （10.3%）. Achievement of pregnancies by ICSI presents the best option but when there are enough stored sperm samples and adequate quality, I UI can be employed. Cryopreservation is nevertheless the best option to preserve future fertility potential and hope for cancer patients.展开更多
Ferroptosis has emerged as a crucial regulated cell death involved in a variety of physiological processes or pathological diseases,such as tumor suppression.Though initially being found from anticancer drug screening...Ferroptosis has emerged as a crucial regulated cell death involved in a variety of physiological processes or pathological diseases,such as tumor suppression.Though initially being found from anticancer drug screening and considered not essential as apoptosis for growth and development,numerous studies have demonstrated that ferroptosis is tightly regulated by key genetic pathways and/or genes,including several tumor suppressors and oncogenes.In this review,we introduce the basic concepts of ferroptosis,characterized by the features of non-apoptotic,iron-dependent,and overwhelmed accumulation of lipid peroxides,and the underlying regulated circuits are considered to be pro-ferroptotic pathways.Then,we discuss several established lipid peroxidation defending systems within cells,including SLC7A11/GPX4,FSP1/CoQ,GCH1/BH4,and mitochondria DHODH/CoQ,all of which serve as anti-ferroptotic pathways to prevent ferroptosis.Moreover,we provide a comprehensive summary of the genetic regulation of ferroptosis via targeting the above-mentioned pro-ferroptotic or anti-ferroptotic pathways.The regulation of proand anti-ferroptotic pathways gives rise to more specific responses to the tumor cells in a contextdependent manner,highlighting the unceasing study and deeper understanding of mechanistic regulation of ferroptosis for the purpose of applying ferroptosis induction in cancer therapy.展开更多
Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments...Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments in learning and memory, speech disorders and repetitive behavior （Telias and Ben-Yosef, 2014）. Common major neurodevelopmental disorders include autism and autism spectrum disorders （ASDs）, fragile X syndrome （FXS）, Down syndrome （DS）, and Rett syndrome （RTT）. They can be collectively described as disorders in which the plasticity of the brain has been severely impaired. The concept of plasticity refers to the brain＇s ability to adapt to and process new information and react accordingly, and it can be classified into three categories： a） molecular plasticity, whenever specific receptors, ion channels, enzymes,展开更多
AIM： To evaluate the effects of omeprazole on gastric mechanosensitivity in humans. METHODS： A double lumen polyvinyl tube with a plas- tic bag was introduced into the stomach of healthy volunteers under fluorograph...AIM： To evaluate the effects of omeprazole on gastric mechanosensitivity in humans. METHODS： A double lumen polyvinyl tube with a plas- tic bag was introduced into the stomach of healthy volunteers under fluorography and connected to a barostat device. Subjects were then positioned so they were sitting comfortably, and the minimal distending pressure （MDP） was determined after a 30-rain adap- tation period. Isobaric distensions were performed in stepwise increments of 2 mmHg （2 min each） starting from the MDR Subjects were instructed to score feel- ings at the end of every step using a graphic rating scale： 0, no perception; 1, weak/vague; 2, weak but significant; 3, moderate/vague; 4, moderate but signifi- cant; 5, severe discomfort; and 6, unbearable pain. Af- ter this first test, subjects received omeprazole （20 mg, after dinner） once daily for 1 wk. A second test was performed on the last day of treatment. RESULTS： No adverse effects were observed. Mean MDP before and after treatment was 6.3 - 0.3 mmHg and 6.2：1：0.5 mmHg, respectively. One subject before and 2 after treatment did not reach a score of 6 at the maximum bag volume of 750 mL. After omeprazole, there was a significant increase in the distension pres- sure required to reach scores of 1 （P = 0.019） and 2 （P = 0.017） as compared to baseline. There were no changes in pressure required to reach the other scores after treatment. Two subjects before and one after omeprazole rated their abdominal feeling 〈 1 at MDP, and mean （±SE） abdominal discomfort scores at MDP were 0.13±0.09 and 0.04±0.04, respectively. Mean scores induced by each MDP ＋ 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 （mmHg） were 1.1±0.3, 2.0±0.4, 2.9±0.5, 3.3±0.4, 4.6±0.3, 5.2±0.3, 5.5±0.2, 5.5±0.3, 5.7±0.3, and 5.4, respectively. After omepra- zole, abdominal feeling scores for the same incremen- tal pressures over MDP were 0.3±0.1, 0.8±0.1, 2.0±0.4, 2.8±0.4, 3.8±0.4, 4.6±0.4, 4.9±0.3, 5.4±0.4, 5.2±0.6, and 5.0±1.0, respectively. A signif- icant decrease in feeling score was observed at intra- bag pressures of MDP ＋ 2 mmHg （P = 0.028） and ＋ 4 mmHg （P = 0.013）, respectively, after omeprazole. No significant score changes were observed at pres- sures ≥ MDP ＋ 6 mmHg. CONCLUSION： Although the precise mechanisms are undetermined, the present study demonstrated that omeprazole decreases mechanosensitivity to mild gas- tric distension.展开更多
文摘Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from 2003-2007 at Government maternity hospital, Osmania medical college, Hyderabad, 666 women with eclampsia and imminent eclampsia were managed. The number of eclampsia and imminent eclampsia (IE) was 532 and 134, respectively. We have analyzed the clinical profile, parity, age, degree of proteinuria, the period of gestation in weeks, the antenatal care, the number of antenatal visits, referrals from other hospitals, the diastolic B.P. at the time of admission, the recurrence of convulsions and the complications. 1) All the cases of eclampsia and IE were managed with magnesium sulphate as an anticonvulsant. 2) Oral nifedipine, IV labetalol, sublingual nifedipine and nitroglycerine infusion were used to control severe hypertension. 3) Prostaglandin E1 (PGE1) was used for induction of labour (IOL), 25 mcg × 4th hrly, vaginal route and 50 mcg for less than 28 weeks gestation, in 290/424 cases of IOL. Other methods of IOL were employed in 134 cases. Results: Eclampsia (n = 532) occurred antepartum in 407 (75.56%), intrapartum in 76 (14.28%), post partum in 46 (8.64%) and intercurrent in 3 (0.5%) patients. The period of gestation was 34 weeks in 340 patients. Induction of labour with misoprostol was done in 290 with vaginal delivery in 235 (81%) and lower segment caesarean section (LSCS) for failed IOL in 55 (19%) and other methods of IOL were used in 134. The total number of deliveries was 656, with vaginal deliveries in 336 (66.46%) patients, ceasarean deliveries in 220 (33.54%) patients. Ten patients died undelivered. Maternal mortality was 17/666—2.55%. Cerebrovascular events were responsible in 13/17 (76.46%) patients, pulmonary embolisim in 2, aspiration pneumonia in one and sepsis in one. The perinatal mortality was 167/582 (28.69%), PNM when birth weight was >1.5 kg was 59/426 (13.84%), intrauterine fetal deaths at admission were 54 (8.5%), there were four sets of twins. Conclusions: 1) More effective measures to control hypertension and routine administration of anticonvulsant, magnesium sulphate to women with eclampsia should be practised from the first referral unit itself. 2) Our caesarean delivery rate of 33.54% in the very high risk cases of eclampsia and imminent eclampsia is very low compared to others. 3) Induction of labour with misoprostol was successful in 81% with consequent reduction in caesarean section rate and morbidity and mortality associated with caesarean deliveries. Misoprostol has proved to be a safe and effective inducing agent in eclampsia. 4) The maternal mortality in our series is 2.55%.
文摘Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Objectives: This study aimed to find incidence, indications, procedures and maternal outcome of re-laparotomy after caesarean delivery. Methods: This was a descriptive cross sectional prospective total coverage hospital based study conducted at Omdurman Maternity Hospital from June 2014 to January 2015. Results: The incidence for re-laparotomy after Caesarean section is (0.66%) and the main indication for re-laparotomy is hemorrhagic events. Re-laparotomy outcome reported 22 cases (64.7%) alive and well and 6 cases (17.6%) alive with morbidity (renal failure and massive blood transfusion complications) and 6 cases (17.6%) of maternal mortality mainly due to sepsis. Conclusion: Re-laparotomy after Caesarean section is contributing to morbidity and maternal mortality. The majority of re-laparotomy was done after emergency Caesarean section. Lacks of skills, experience;safety measures of perfection and infection control are points to be concern.
文摘Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months;and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.
文摘Introduction: The association of diabetes and pregnancy is associated with a significantly higher risk of perinatal morbidity and mortality. The aim of this study was to investigate the perinatal morbidity and mortality associated with maternal diabetes at the Issaka Gazoby Maternity Hospital in Niamey. Methodology: This was a prospective case-control study conducted from April to September 2021 at the Issaka Gazoby Maternity Hospital in Niamey. “Cases” were neonates born to diabetic mothers, and “controls” were neonates born to non-diabetic mothers. The main dependent variable was the occurrence of perinatal complications. Analysis was performed using Epi info software 7.2.1. Pearson’s Chi2 test or Fisher’s exact test were used (p Results: Of the 2,225 admissions during the study period, 31 newborns were born to diabetic mothers (1.4%). Diabetic mothers were 2.8 times more likely to have a history of abortion (67.7% vs. 28.6%;OR = 2.82;p = 0.001). Similarly, a history of macrosomia was found in 29.0% of diabetic mothers versus 9.5% of controls (OR = 2.15;p = 0.01). Macrosomia was also more common in newborns of diabetic mothers (38.7% vs. 9.5%;OR = 2.63;p Conclusion: The risks of ante- and perinatal complications such as abortion, fetal macrosomia and stillbirth, as well as neonatal pathological events (macrosomia and malformations) were greater in newborns of diabetic mothers.
文摘<strong><em>Backgrounds</em></strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Teenage pregnancies are generally considered as a high-risk however, sufficient data is lacking in the area, Cairo Egypt. We attempted to </span><span style="font-family:Verdana;">determine whether teenage pregnancies show poorer outcomes than adult-age </span><span style="font-family:Verdana;">pregnancies. </span><b><i><span style="font-family:Verdana;">Objectives</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> Finding out the prevalence of teenage pregnancy and its maternal and fetal outcome in comparison. </span><b><i><span style="font-family:Verdana;">Subjects</span></i> <i><span style="font-family:Verdana;">and</span></i> <i><span style="font-family:Verdana;">methods</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> A retrospective analytical case-control study was conducted on patients who had attended for delivery at Al-Galaa Maternity Teaching Hospital during the period of one year from March 2015 to February 2016. A total of included 538 patients aged 16 - 19 years as study group and adult age group: included 609 patients aged 25 - 29 years as the control group. The only primigravid was enrolled. The study records were retrieved for review. Comparisons were made between the two groups regarding maternal demographics, socioeconomic status, medical disorders, major antenatal complications, the outcome of labor, mode of delivery, and perinatal complications. </span><b><i><span style="font-family:Verdana;">Results</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> The prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered the significant prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered significant. Teenagers had a lower antenatal care attendance (63.8% vs 76.7%;P = 0.001), a higher incidence of Eclampsia (2.1% vs 0%;P = 0.000), vaginal deliveries (70.1% vs 51.9%;P = 0.000). And a higher maternal ICU admission (1.4% vs 0.0.7%), and maternal death (0.5% vs 0%),especially in low socioeconomic. On the other hand, the adult group pregnancies had a higher incidence of gestational hypertension, gestational diabetes, and cesarean delivery. </span><b><i><span style="font-family:Verdana;">Conclusions</span></i><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> Teenager primigravid women should be considered as a high-risk pregnancy and thus require special medical attention to avoid adverse maternal and neonatal outcomes.</span></span></span></span>
文摘Procidentia is one of complications of pregnancy and childbirth. The challenge of treatment is to preserve fertility if needed and to find effective methods with rapid learning curve. Our technique—Isam technique—fulfills these needs with a short hospital stay, very low risk of complications and relapse, a rapid learning curve as well, and no need for long contraceptive methods after operation.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
文摘Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on a large postpartum ovarian cyst in a 40-year-old patient. The diagnosis was suspected based on clinical and ultrasound signs and confirmed by exploratory laparotomy. The appearance of the cyst was suggestive of a mucinous cystadenoma of the ovary. The treatment was radical by performing an adnexectomy. The surgical piece weighed 5.2 kg. The postoperative course was simple. Anatomopathological examination had not been carried out;the parents had buried the operating piece.
文摘Background: Maternity nurses are frontline health professionals in the COVID-19 pandemic who may confront life-altering challenges. Studies that evaluated the impact of COVID-19 on maternity nurses’ daily lifestyles are limited. Objective: The aim of this study was to examine the changes in health-enhancing behaviors, such as eating habits and lifestyle behaviors, during the COVID-19 pandemic among nurses working in a maternity hospital. Methods: This was a cross-sectional study that surveyed maternity nurses working in a major government maternity hospital in Kuwait. Data were collected between January and February 2021. Results: A total of 336 participants completed the questionnaire. Normal weight was perceived by 88 (26.2%) of the participants, while 56 (16.7%) had a Body Mass Index indicating obesity. Weight gain during the pandemic was reported by 128 (38.1%) participants and 91 (27.1%) of the sample gained one to three kilograms. The findings showed low adherence to the Mediterranean diet 5.3 ± 2.5 points. Sleep hours decreased significantly during the crisis, with 113 (33.6%) of participants sleeping 7 to 9 hours during the COVID-19 situation compared to 136 (40.5%) before the pandemic (p Conclusion: Maternity nurses revealed low adherence with the healthy diet, with almost a third of participants having self-reported weight gain. Further, the sleeping patterns and the practicing of physical activities were negatively affected by COVID-19 pandemic.
文摘Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.
文摘Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.2%), an obstetric gynaecology resident (six patients, 2.5%), or a general practitioner with district surgical expertise (three patients, 1.3%). In the majority of cases (180 patients, 75.3%), total hysterectomy was performed. The incidence of maternal mortality (26 patients, 10.9%), and perinatal mortality (223 newborns, 93.4%) was notably elevated in our series. Conclusion: Our findings are in close alignment with those previously documented in the literature. The practice of emergency obstetric hysterectomy is a common occurrence in our region. It is considered a last resort when conservative procedures have failed or are not an option. Improved obstetric management would result in a reduction in the number of cases of haemostatic hysterectomy. The availability of blood products is expected to improve maternal prognosis.
文摘Objective: to analyze the channels, problems and positions of pediatric complaints in a secondary maternal and child health care hospital in Beijing, so as to formulate corresponding preventive measures. Methods: the data of 48 complaints of pediatrics in our hospital from January 2018 to October 2021 were analyzed retrospectively, and the total number of complaints, complaint channels, complaint problems and complaint posts were compared respectively. Results: in 48 cases, the main channel of complaint was 12345 citizen hotline, accounting for 48.0% (23/48);The main complaints were medical quality, accounting for 27.1% (13/48);The main complaint posts were general outpatient service, accounting for 66.7% (32/48). Conclusion: the hospital should strengthen the training, improve the humanistic care quality and doctor-patient communication ability of doctors, and improve the complaint management system, so as to formulate corresponding preventive measures and reduce the incidence of complaints.
文摘Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
文摘AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) testing.The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ criteria.RESULTS:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD group.The FH group included 22 patients with no reflux involvement.Sex, age, and body mass index did not differ significantly between the groups.The mean SF-36 values were < 50(normal) for all scales in these groups, with no significant differences.The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms.The QUEST and the FSSG scores did not differ significantly between the groups.Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant differences.CONCLUSION:Clinical characteristics of the FH and PPI-refractory ENRD groups were similar.Therefore,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them.
文摘OBJECTIVE： Elevated natural killer lymphocyte cytotoxicity（NKc） has been linked with reproductive problems in women. Here we evaluate the potential benefit of cupping therapy（CT） in reproductionrelated immune responses.METHODS： This was a pilot clinical study. Participants were he althy fe male volunteers（n = 23） with elevated NKc, and received repeated CT 3 times over 5 d（inner pressure 40–50 kPa, 40 min; 12–1 5 cups）. Lymphocyte subsets, NKc and NK lymphocyte activity（NKa） were measured in blood on day 0（initial levels, before the first treatment） and days 3, 10 and 17 after the last CT treatment, using the K562-stimulated CD69 expression assay.RESULTS： As a result of CT manipulations NKa was reduced on days 3 and 10, and NK percentage was reduced on day 10. NKc was most sensitive to CT treatment, resulting in their decreased counts at 3, 10 and 17 d post CT. CT treatment decreased NKc in the majority of individuals（87%）, but the magnitude of the effect was variable. Out of 23 subjects 9（39.1%） had a 2–3 fold decrease of NKc on days 3, 10 and 17; 11（47.8%） started to show a decrease in NKc later, or more quickly returned to base levels; and only 3（13%） subjects displayed no effect of CT on NKc. Expectedly, no changes in T-cell subsets（CD3CD4, CD3CD8, HLADR, CD158a） were observed after CT.CONCLUSION： CT decreased NK cell numbers, their activity and cytotoxicity. Low cost, safety, noninvasive nature and ease of administration make CT a promising approach for NKc down-regulation.
文摘The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.
文摘Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that are available and the success rates of these treatments have not been investigated in depth. The medical records of 682 patients who cryopreserved sperm cells due to cancer treatment were analyzed. Seventy of these patients withdrew their frozen sperm for fertility treatments over a 20-year period （most within the first 4 years after cryopreservation）. Sperm quality of different malignancies and outcomes of assisted reproduction treatment （ART） for pregnancy achievement in relation to the type of treatment and the type of malignancy were evaluated. The results showed that the rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10.3%. Sperm quality indices differed between different types of malignancies, with the poorest quality measured in testicular cancer. Conception was achieved in 46 of the 184 ART cycles （25%）, and resulted in 36 deliveries. The use of intracytoplasmic sperm injection （ICSI） methodology yielded a significantly higher pregnancy rate （37.4%） than intrauterine insemination （IUI; 11.5%） and was similar to other groups of infertile couples using these modalities. In vitro fertilization （IVF） failed to produce pregnancies. In conclusion, the rate of use of cryopresseved sperm in cancer patients is relatively low （10.3%）. Achievement of pregnancies by ICSI presents the best option but when there are enough stored sperm samples and adequate quality, I UI can be employed. Cryopreservation is nevertheless the best option to preserve future fertility potential and hope for cancer patients.
基金the funding support from National Natural Science Foundation of China(82103272 to Y.Zhang)Xi’an Jiaotong University(xtr042021011 to Y.Zhang)+1 种基金Department of Science and Technology of Shaanxi Province(2022KW-48 to J Chen)supported by Top Young Talents Programme at Xi’an Jiaotong University。
文摘Ferroptosis has emerged as a crucial regulated cell death involved in a variety of physiological processes or pathological diseases,such as tumor suppression.Though initially being found from anticancer drug screening and considered not essential as apoptosis for growth and development,numerous studies have demonstrated that ferroptosis is tightly regulated by key genetic pathways and/or genes,including several tumor suppressors and oncogenes.In this review,we introduce the basic concepts of ferroptosis,characterized by the features of non-apoptotic,iron-dependent,and overwhelmed accumulation of lipid peroxides,and the underlying regulated circuits are considered to be pro-ferroptotic pathways.Then,we discuss several established lipid peroxidation defending systems within cells,including SLC7A11/GPX4,FSP1/CoQ,GCH1/BH4,and mitochondria DHODH/CoQ,all of which serve as anti-ferroptotic pathways to prevent ferroptosis.Moreover,we provide a comprehensive summary of the genetic regulation of ferroptosis via targeting the above-mentioned pro-ferroptotic or anti-ferroptotic pathways.The regulation of proand anti-ferroptotic pathways gives rise to more specific responses to the tumor cells in a contextdependent manner,highlighting the unceasing study and deeper understanding of mechanistic regulation of ferroptosis for the purpose of applying ferroptosis induction in cancer therapy.
文摘Neurodevelopmental disorders are characterized by an abnormal development of the central nervous system, leading to a myriad of symptoms and diseases, including intellectual disability, attention deficits, impairments in learning and memory, speech disorders and repetitive behavior （Telias and Ben-Yosef, 2014）. Common major neurodevelopmental disorders include autism and autism spectrum disorders （ASDs）, fragile X syndrome （FXS）, Down syndrome （DS）, and Rett syndrome （RTT）. They can be collectively described as disorders in which the plasticity of the brain has been severely impaired. The concept of plasticity refers to the brain＇s ability to adapt to and process new information and react accordingly, and it can be classified into three categories： a） molecular plasticity, whenever specific receptors, ion channels, enzymes,
基金Supported by A Grant-in-Aid for Scientific Research from the Aichi Medical University Alumni Association, in part
文摘AIM： To evaluate the effects of omeprazole on gastric mechanosensitivity in humans. METHODS： A double lumen polyvinyl tube with a plas- tic bag was introduced into the stomach of healthy volunteers under fluorography and connected to a barostat device. Subjects were then positioned so they were sitting comfortably, and the minimal distending pressure （MDP） was determined after a 30-rain adap- tation period. Isobaric distensions were performed in stepwise increments of 2 mmHg （2 min each） starting from the MDR Subjects were instructed to score feel- ings at the end of every step using a graphic rating scale： 0, no perception; 1, weak/vague; 2, weak but significant; 3, moderate/vague; 4, moderate but signifi- cant; 5, severe discomfort; and 6, unbearable pain. Af- ter this first test, subjects received omeprazole （20 mg, after dinner） once daily for 1 wk. A second test was performed on the last day of treatment. RESULTS： No adverse effects were observed. Mean MDP before and after treatment was 6.3 - 0.3 mmHg and 6.2：1：0.5 mmHg, respectively. One subject before and 2 after treatment did not reach a score of 6 at the maximum bag volume of 750 mL. After omeprazole, there was a significant increase in the distension pres- sure required to reach scores of 1 （P = 0.019） and 2 （P = 0.017） as compared to baseline. There were no changes in pressure required to reach the other scores after treatment. Two subjects before and one after omeprazole rated their abdominal feeling 〈 1 at MDP, and mean （±SE） abdominal discomfort scores at MDP were 0.13±0.09 and 0.04±0.04, respectively. Mean scores induced by each MDP ＋ 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 （mmHg） were 1.1±0.3, 2.0±0.4, 2.9±0.5, 3.3±0.4, 4.6±0.3, 5.2±0.3, 5.5±0.2, 5.5±0.3, 5.7±0.3, and 5.4, respectively. After omepra- zole, abdominal feeling scores for the same incremen- tal pressures over MDP were 0.3±0.1, 0.8±0.1, 2.0±0.4, 2.8±0.4, 3.8±0.4, 4.6±0.4, 4.9±0.3, 5.4±0.4, 5.2±0.6, and 5.0±1.0, respectively. A signif- icant decrease in feeling score was observed at intra- bag pressures of MDP ＋ 2 mmHg （P = 0.028） and ＋ 4 mmHg （P = 0.013）, respectively, after omeprazole. No significant score changes were observed at pres- sures ≥ MDP ＋ 6 mmHg. CONCLUSION： Although the precise mechanisms are undetermined, the present study demonstrated that omeprazole decreases mechanosensitivity to mild gas- tric distension.
