Quality of hospital services during New Year holiday (Nowruz) in Iran

Journal of Public Health - Iranian New Year, with long consecutive holidays, although it is celebrated and enjoyed, might influence the quality of services provided by hospitals. The present study...     

Assessment of spermicidal activity of the antimicrobial peptide sarcotoxin Pd: A potent contraceptive agent

Objectives In searching for new spermicidal microbicides for use in the prevention of unplanned pregnancy and sexually transmitted infections (STIs) we investigated the spermicidal and cytotoxicity activities of the antimicrobial peptide sarcotoxin Pd.

Methods Washed sperm from 10 healthy, normal volunteers was treated with different concentrations of sarcotoxin Pd. Sperm motility and morphology were assessed at 0, 0.3, 5, 10 and 15 min. The cytotoxicity of sarcotoxin Pd in normal human cervical HeLa cells was measured. Percentage cell survival was expressed as the number of live cells in the test group.

Results The cytotoxic effect of sarcotoxin Pd was concentration-dependent. Significant cytotoxicity was observed at concentrations above 24 μg/ml. Sarcotoxin Pd immobilised 100% of spermatozoa at a dose of 90 and 80 μg/ml after 0.3 and 5 min, respectively, and immobilised 50% of spermatozoa after 15 min at lower doses. Sarcotoxin Pd inhibited sperm motility in a dose-dependent manner. The peptide immobilised sperm within 20 s at its maximal effective concentration of 90 μg/ml.

Conclusions Sarcotoxin Pd appears to be a good candidate for a contraceptive agent in the prevention of unplanned pregnancy and STIs.     

Cholangiocarcinoma in patients with primary sclerosing cholangitis: a multicenter case-control study

Patients with primary sclerosing cholangitis (PSC) have a significantly increased risk of developing cholangiocarcinoma (CCA). Risk factors for developing such a complication are not well defined. We conducted a multicenter, case-control study to determine the risk factors and possible predictors for CCA in patients with PSC. The demographic, clinical, and laboratory features of 26 PSC patients with CCA diagnosed over a 7-year period at eight academic centers were compared with 87 patients with PSC but no CCA (controls). There was no statistically significant difference in demographics, smoking, signs or symptoms or complications of PSC, indices of disease severity (Mayo Risk score or Child-Pugh score), frequency or duration or complications of inflammatory bowel disease (IBD), frequency of biliary surgery, or therapeutic endoscopy between the two groups. Alcohol consumption was significantly associated with CCA in patients with PSC (odds ratio: 2.95; 95% CI: 1.04-8.3). Serum carbohydrate antigen 19-9 (CA 19-9) was significantly higher in patients with CCA than those without (177 +/- 89 and 61 +/- 58 U/mL, respectively; P =.002). A serum CA 19-9 level > 100 U/mL had 75% sensitivity and 80% specificity in identifying PSC patients with CCA. In conclusion, alcohol consumption was a risk factor for having CCA in PSC patients. The indices of severity of liver disease were not associated with CCA in patients with PSC. Serum CA 19-9 appeared to have good ability to discriminate PSC patients with and without CCA.     

Medial patellofemoral ligament reconstruction: a novel approach

Recurrent patellar instability is common, and multiple procedures have been described for its treatment. Medial patellofemoral ligament reconstruction can be successful in patients who have an incompetent medial patellofemoral ligament or who have failed medial patellofemoral ligament repair and present with recurrent patellar instability. This article describes a novel approach to medial patellofemoral ligament reconstruction using a folded hamstring allograft with a new knotless suture anchor and bio-interference screw fixation. The principal advantage of this construct is the ability to definitively fix the medial patellofemoral ligament soft-tissue graft on the femur and provisionally fix the graft to the patella while assessing for reasonable medial patellofemoral ligament isometry throughout the arc of knee motion.     

Delayed repair of a ruptured pectoralis major muscle. A case report

Repair of a pectoralis major muscle rupture at the tendinous insertion into the humerus was successfully performed 13 years after the initial injury. Repair was possible only because the ruptured sternal portion of the muscle was scarred to the intact clavicular portion and therefore had not retracted. The attachment of the avulsed sternal head to the intact clavicular head enabled successful restoration of strength and function, as well as normal contour and appearance of the pectoralis major muscle complex.     

Orlistat in the treatment of NASH: a case series

Nonalcoholic steatohepatitis is now recognized as a common chronic liver disorder. Up to 16% of affected patients may progress to cirrhosis. The incidence and prevalence of this disease are noted to be increasing, in parallel with the nationwide increase in obesity and diabetes. Treatment options for these patients remain quite limited, however. Weight reduction has been advocated, but there are little data to support this practice, as most patients are unable to comply with the proper dietary modifications. We report three obese patients with biopsy-proven nonalcoholic steatohepatitis treated for 6-12 months with a weight reduction medication, orlistat, who lost between 22-42 lb, and had significant clinical and histopathological improvement on follow-up.     

Two primary osteosarcomas in a patient with Rothmund-Thomson syndrome

Rothmund-Thomson syndrome is an autosomal recessive disorder characterized by poikilodermatous skin changes that develop in infancy. Associated manifestations include juvenile cataracts, sparse hair, short stature, skeletal defects, dystrophic nails and teeth, and hypogonadism. An increased incidence of malignancy, including osteosarcoma, has been reported in patients with Rothmund-Thomson syndrome. The molecular basis of the disorder is not known. This report describes a patient with Rothmund-Thomson syndrome in whom two primary osteosarcomas developed 12 years apart. The presentation, diagnosis, and treatment of osteosarcoma in this patient with Rothmund-Thomson syndrome are described. Cytogenetic and molecular analysis of peripheral blood and skin fibroblasts had low level mosaicism for trisomy of chromosomes 2 and 8. Although several patients have been described with mosaic trisomy 8 and i(2q) (mosaic isochromosome for the long arm of chromosome 2), the patient described here is the first to have mosaic trisomy for the entire chromosomes 2 and 8. The cytogenetic findings in this patient are consistent with an underlying defect in chromosomal stability.     

Does sperm DNA fragmentation have negative impact on embryo morphology and morphokinetics in IVF programme?

Evaluation of sperm integrity may predict the in vitro fertilisation (IVF) outcomes. The aim was to evaluate the relationship between the sperm DNA fragmentation (sDNAf) with embryo morphology and morphokinetic using time-laps monitoring (TLM) and to select the best time points for normalisation in IVF setting. After evaluating the fertilisation and pronuclei (Z) scoring, 328 normally fertilised oocytes were assessed to time of pronuclei fading, time of 2 to 8 discrete cells (t2–t8) and abnormal cleavage patterns, such as multinucleation, direct cleavage, reverse cleavage and fragmentation. Sperm chromatin dispersion (SCD) assay was used for assessment of prepared sperm chromatin status. SCD was categorised into 4 groups of <6.5, 6.5–10.7, 10.7–20.1 and >20.1. The finding showed significant differences in t6 (p = .012), t7 (p = .045), t8 (p = .013) and s1 (p = .001) between 4 SCD groups. When morphokinetic variables were normalised to tPNf, this difference was observed in t2 (p = .003) and t6 (p = .017). Subsequently, the percentage of top quality embryos and Z₁ scoring were dependent to the sDNAf rate. In conclusion, tPNf was the best reference time point in IVF cycles. Also, we found high sDNAf rate had no negative impact on embryo morphology and morphokinetics in conventional IVF.     

Protective effects of royal jelly on testicular torsion induced ischaemia reperfusion injury in rats

This study was performed to investigate the protective effects of royal jelly (RJ) on a testicular torsion-induced ischaemia/reperfusion (I/R) injury in adult rats. A total of 40 male Wistar rats were divided into four groups, including 10 rats in each group: Group 1 (sham), Group 2 (Control), group 3 (I/R rats treated with 100 mg/kg RJ for 50 days after torsion) and group 4( I/R rats treated with 20 mg/kg vitamin C for 50 days after torsion). Testicular torsion was created by rotating the right testes 720° a clockwise direction for 90 min. The levels of testosterone were measured by ELISA. Pathological evaluation, mean maturity and quality of the seminiferous tubules were used. Results showed that the testicular histopathology standards and testosterone levels changes were statistically significant in groups 3 and 4. The results obtained in this study may suggest that RJ like vitamin C had protective effects on a testicular ischaemia/reperfusion-induced injury in rats.