Dye Test Research Articles

In vitro antifungal and antibiofilm activities of auranofin against itraconazole-resistant Aspergillus fumigatus.

Infections caused by azole-resistant Aspergillus are a rising public health threat with high mortality rates, high treatment costs and limited available antifungals, indicating an urgent need for new antifungals or strategies. Our aim was to investigate antifungal and antibiofilm activities of auranofin, an FDA-approved anti-antirheumatic drug. Fungal susceptibility testing for auranofin was carried out by the broth-based microdilution methods. Cell viability treated by auranofin was tested by resazurin dye testing. The synergistic effect of auranofin and antifungal drugs was evaluated using checkboard assay. The inhibitory of biofilms were measured by crystal violet staining. Gene expression level analysis and enzyme activity was investigated with qRT-PCR analysis and DTNB assay. The key amino acid residues in the binding of auranofin with A. fumigatus thioredoxin reductase (AfTrxR) were indicated by structural analyses, site-directed mutagenesis, and microscale thermophoresis (MST) assays. Auranofin has fungicidal activity and in vitro antifungal spectrum including Aspergillus flavus, Aspergillus fumigatus, Aspergillus terreus, Aspergillus niger, even itraconazole (ITC)-resistant A. fumigatus. Additionally, it has antibiofilm activities against ITC-resistant A. fumigatus by reducing the expression level of SomA and MedA. Moreover, we discovered a synergistic effect of auranofin and ITC or amphotericin B against ITC-resistant A. fumigatus. Auranofin downregulated the gene transcription of AfTrxR, and strongly inhibited the enzyme activity of AfTrxR through interacting with residues C145 and C148. Auranofin has fungicidal and antibiofilm activities in Aspergillus spp. and is also a potentiator of ITC or amphotericin B in vitro.

A prospective observational 2D/3D/4D hysterosalpingo contrast sonography using mixture of lignocaine gel and normal saline as contrast in patients undergoing infertility investigations

Background and aimHysterosalpingo contrast sonography (HyCoSy) is a well-tolerated diagnostic tool to examine the uterus, ovaries, fallopian tubes, and pelvis. It has some advantages over other techniques, such as X-ray hysterosalpingography (HSG), laparoscopy, and dye intubation. This prospective study aimed to investigate the use of 2D/3D/4D HyCoSy, using lignocaine gel and normal saline as a contrast agent, to assess tubal patency and uterine abnormalities in infertile women. MethodMore than 5000 infertile cases were evaluated by HyCoSy 2D/3D/4D test using lignocaine gel as a contrast agent during the period of 2016–2022 at Shilpa Scanning Center, Andhra Pradesh. Among the subjects studied, a total of 850 cases were randomly selected to assess tubal patency. Of 850 patients, 54 had X-ray HSG reports that were reassessed using 2D/3D/4D HyCoSy. During the test, we also assess the intensity of the pain. ResultsOut of 850 infertile patients, 603 (70.94%) had primary infertility, and 247 (29.06%) had secondary infertility. The fallopian tubes were found to be patent in 702 (82.59%) of these patients, while 80 (9.41%) had unilateral occlusion and 68 (8%) had bilateral occlusion. Among the 54 patients with previous reports of X-ray HSG, three were misdiagnosed as bilateral obstruction and six as unilateral obstruction, and these misdiagnoses were confirmed by 2D/3D/4D HyCoSy using lignosal contrast and laparoscopic dye testing. During the HyCoSy procedure, 772 women (90.82%) reported mild pain that was less severe than menstrual pain. ConclusionsThe 2D/3D/4D-HyCoSy with lignosal gel as a contrast agent could be a promising tool for detecting fallopian tube patency and uterine abnormalities.

Causes of Infertility among the Couples Who are Attending the Infertility OPD of BSMMU

Introduction: Infertility may be defined as inability to conceive within one year of unprotected regular coitus. Approximately 85 – 90% of healthy young couples conceive within 1 year, most within 6 months1. Infertility therefore affects approximately 10 – 15% of couples and represents an important part of clinical practice2. A general classification of causes of infertility are male 35 – 40%, female 40 – 50% (tubal 25%, ovulatory 20% and cervical 1 – 2%), sexual 10% and unknown 10%3. More than one factor per couple accounts for the total percentage appearing to exceed 100%. Objective: To assess the determinants of infertility among the infertile couples both male and female attending the outpatient department of infertility unit of the department of obstetrics and gynaecology of Bangabandhu Sheikh Mujib Medical University , Shahbagh, Dhaka. Materials & Methods: This prospective observational study was conducted in the Infertility unit, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period from 01.07.2018 to 31.12.2021. Five hundred infertile couples were recruited from the out-patient department of infertility unit who came to take treatment for their infertility problem. Data were collected from the couples by data collection sheet and the data were plotted in the tables. The data were analyzed by SPSS program, version 28. Results: The socio-demographic characteristics of the study subjects (n = 500).Husbands age group was 22 -55in years, Mean ± SD (34.0 ± 5.9). Age of the female partners was 18 – 44 years, mean ± SD (27.1 ± 5.2). Majority of the female study subjects had secondary level of education (49.4%), where as in male study subjects secondary level of education was 30.4%, followed by graduates (29.6%). Occupation of female partners was mostly housewife = 395 (79.0%), occupation of male partners was mostly service = 356 (71.2%). Regarding religion, Muslims were 476 (95.2%), others were 24 (4.8%). Majority of them hailed from rural area (62%). According to BMI, majority of female were overweight (56%). Among the respondents, majority of them had primary infertility (59.8%) and the rest (40.2%) had secondary infertility. Regarding hormonal status of infertile women, most of them (94%) had serum FSH below normal (< 3U/L), serum LH below normal (< 2U/L) in 96% patients, Serum TSH above normal (>4.5 mU/L) in 49.0% patients, serum FT4 above normal (>21 pml/L) in (60.8%) patients, serum Prolactin level above normal (>630 mU/L) in 27.8) patients. Diabetes: In male = 28 (5.6%).Mumps: In male = 7 (1.4%). Chicken pox: In male = 18 (3.6%). Hypertension: In male = 10 (2.0%). Orchitis: In male = 6 (1.2%). Personal history of husband: Smoking = 129 (25.8%). In male patients, Testosterone level normal (10 – 30 nmol/L) in 133 (26.6%) patients and above normal (>30 nmol/L) in 367 (73.4%) patients. The semen analyses of the husbands of the infertile female patients shows, quality of semen poor (<4%) in 305 (61%) patients. Regarding semen quality, oligospermia (<15 million/ml) was in 480 (96%) patients and azospermia (0% count) in 20 (4%) patients. In case of motility of sperms, rapid linear below normal (<50%) was in 90 (18%). In case of slow linear (SL), below normal (<15%) in 324 (64.8%) patients. In case of morphology of sperms, below normal (<14million/ml) in 25 (5%) patients. Regarding structural abnormalities of female organs bicornuate uterus was found in 15.2% patients, abnormal uterine cavity in 11.4% patients. In 13.0% patients’ abnormal right ostium were found and in 12.6% patients’ abnormal left ostium were found. Intrauterine adhesion was found in 35.2% patients and submucus fibroid in 17.6% patients. Abnormal right fallopian tube was found in 33.2% patients and abnormal left fallopian tube was found in 34.2% patients. Dye test in 42.4% patients were negative that means the tubes were blocked. Conclusion: This study shows that a significant percentage of both male and female are suffering from infertility. The major causes of male infertility are partly hormonal, structural abnormalities of male genitalia, infection of genital tract, and partly psychological.Causes of female infertility are mostly hormonal, structural abnormalities of the uterus, fallopian tubes, infection of the genital tract and partly psychological. Medicine Today 2023 Vol.35(1): 20-26

Modified external revision-DCR in previous failed endonasal, transcanalicular or external-DCR: technical strategy and teaching Pearls for success.

Objective: To report perioperative findings of patients with multiple failed-dacryocystorhinostomy (DCR) and to determine the success rate of revision external (rEx-DCR) performed by a modified technique. Methods: Thirty-one eyes of 31 patients (19 women, 12 men) with recurrent dacryocystitis or epiphora following at least one previous failed-DCR were assessed regarding the time from initial surgery to recurrence and revision surgery, type of primary surgery (endoscopic, transcanalicular, Ex-DCR), recurrence number, stent usage and the success rate. Relief of epiphora and positive dye test were established as functional and anatomical successes, respectively. Results: The mean age was 43.0 years (8-78), with a mean follow-up period of 21.4 months (6-46). The mean reoperation number was 1.4 (1-5). The mean time from initial surgery to recurrence was 15.2 months (1-55) and to rEx-DCR, 19.8 months (4-65). Untouched medial canthal ligament was observed in 28 (90.3%), improper rhinostomy location in 26 (83.8%), inadequate osteotomy size in 25 (80.6%), single-anterior-flap-only in 5 (16.1%), membranous ostial scar formation in four (12.5%) and no flap in three (9.6%) patients. The success rate was 93.5%, which was lower than our primary modified Ex-DCR (99.1%). Conclusions: The most common reasons for recurrence were small and unsuitable osteotomy locations with intact medial canthal ligaments. "Double-mucosal flap" approach with an anterior sacco-mucosal complex suspension increases the functional success rate, and stent implantation is not obligatory if canalicular problems or small/ atrophic sacs do not exist. The knowledge of technical strategy and teaching pearls improves the success rates of primary and revision surgeries. Abbreviations: DCR = dacryocystorhinostomy, Ex-DCR = external DCR, EE-DCR = endoscopic endonasal DCR, TC-LA-DCR = transcanalicular laser-assisted DCR.

Measurement of the travel time in the upper Yellow River in 2015

The solute travel time in steady and gradually varied flow in rivers is necessary for waste transport studies, in particular, to evaluate the behavior of accidentally spilled soluble substances in streams. This study conducted two dye tests on the Donghe reach within Baotou in the upper Yellow River to measure the travel times in October 2015. It reconstructed the leading and trailing edge missed data by extension from time-concentration curves developed by fitting a three-parameter log-normal (3PLN) equation to the discretely observed data. It also calculated the travel times, dispersion rates, and longitudinal dispersion coefficients. The results show that the calculated travel rates of the centroid are less than the velocities at the Baotou hydrometric station. The calculated longitudinal dispersion rates ranged from about 0.22 meters per second to 0.68 meters per second. Using the nonlinear best fit method, a dispersion model for an instantaneous injection of tracer gave the longitudinal dispersion coefficients ranging from about 76 square meters per second to about 304 square meters per second. However, the ones generated by some commonly used empirical equations are at least 2.6 times them. Tracing tests are essential to obtain helpful information for pollutant transport studies.

Evaluation and Management of Mechanical Infertility Using Minimal Access Surgery

Introduction: Tubal and peritoneal pathologies are one of the most common causes responsible for female infertility corresponding to 30%–40% of cases. The use of combined hysteroscopy and laparoscopy (HL) has now become a gold standard in the diagnosis and subsequent treatment of these pathologies. Aim of the Study: (1) Evaluation of infertile females for tubal and uterine pathologies using combined HL as a diagnostic aid. (2) To find out the feasibility of providing therapeutic management concurrently. Materials and Methods: This study was conducted from 2018 to 2019 on 100 married females in the age group of 20–45 years with primary or secondary infertility of > 1-year duration after ruling out male causes and hormonal causes of infertility. Laparoscopy and hysteroscopy were performed in a single session; methylene blue dye testing was done. Any relevant positive findings on hysterolaparoscopy were noted, and the incidence of different lesions was calculated. Surgical procedures wherever possible were carried out and tabulated accordingly. Results: Out of all patients subjected to combined HL, positive findings were noted in 76% of the cases. The most common hysteroscopic pathology in our patients was intrauterine adhesions (9.2%), followed by polyp (7.9%) and septum (6.6%). Similarly, on laparoscopy, the common findings were adhesions (23.7%), endometriosis (21.1%), myomas (17.1%), and hydrosalpinx (13.2%). Unilateral tubal block was seen in 15.8% and bilateral tubal block in 13.2% of the patients. Hysteroscopic procedures were done in 40.8% of the patients and laparoscopic procedures in 60.5% of the patients. Conclusion: From our study, we concluded that combined HL serves as an important diagnostic as well as a therapeutic modality in female infertility. Direct visualization of the uterine cavity and the ability to manipulate uterus and adnexa and perform any procedure required l(cannulation, septal resection, adhesiolysis etc.) all in a single session makes combined HL a far more superior tool for evaluation and treatment of infertility.

ROLE OF GENITAL TUBERCULOSIS IN SUB-FERTILE WOMEN

OBJECTIVE: To evaluate role of Acid fast bacilli culture (AFB) in sub-fertile women undergoing laparoscopy and dye test with endometrial biopsy. METHODS: This cross-sectional study was conducted from 1st January 2020 to 30th April 2021, on 108 cases of subfertility, enrolled through non-probability consecutive sampling technique, for diagnostic laparoscopy & dye test with endometrial biopsy for AFB culture. We included all women of reproductive age with ≥2 years of subfertility, normal menstrual history, hormonal assay and normal male-factor. All women with comorbidities, women having contraindications for anaesthesia & couple with male-factor subfertility were excluded. Data analysis was done by SPSS version-20. RESULTS: Seventy-two (66.7%) women had primary and 36 (33.3%) had secondary subfertility. Duration of subfertility was >5 years in 63 (58.3%) cases. Ninety-seven (89.8%) patients had bilateral patent tubes. Majority of patients (n=46/108; 42.6%) were aging 32-38 years. Endometrial biopsy of 22 (20.4%) cases were positive for AFB culture. Out of AFB-positive cases, 17 (77.3%) had primary and 5 (22.7%) had secondary sub-fertility. All AFB-positive cases had patent tubes (unilateral n=5/22; bilateral n=17/22). Common laparoscopic findings were tortuous tubes (n=30; 27.8%) and clumped end fimbrial (n=24, 22.2%). CONCLUSION: In our study, endometrial sampling of 20.4% cases were positive for AFB culture. Although female genital tuberculosis constitutes a small proportion of extra-pulmonary tuberculosis, but it has an immense effect on fertility. Thus without challenging the superiority of laparoscopy, AFB culture could be considered a judicious part of subfertility workup in low resource countries carrying high burden of disease.

Influence of Paulownia fortunei (Seem.) Hemsl. roots on preferential flow in the red soil hilly region

Preferential water flow in soil significantly affects runoff, water infiltration, storage, groundwater environment, and soil stability. Plant roots positively affect preferential flow development. This study explored the relationship between the root system of <i>Paulownia fortunei</i> (Seem.) Hemsl. and preferential flow using dyeing tracer test and image analysis techniques. A typical red soil hilly region on the outskirts of Guilin City (Guangxi, China) was selected as the study area. A Bright Blue solution was used to visualize the pathways followed by the infiltrated water in simulated rainfall experiments, and Image Analyzer of Plants was used to analyze the root length, surface area, and volume. The results revealed significant differences in the root surface area density of coarse roots (RSAD-CR) and length index of preferential flow (LI) among soil profiles at various distances from the tree trunk. The root volume density of coarse (RVD-CR) and total roots (RVD-TR), the root length density of coarse roots (RLD-CR), and RSAD-CR were significantly correlated with the characteristics of dyeing morphology. Conversely, the root length density and root surface area density of fine (RLD-FR and RSAD-FR, respectively) and total roots (RLD-TR and RSAD-TR, respectively), and the root volume density of fine roots (RVD-FR) were not significantly correlated with the characteristic parameters of dyeing morphology. The root systems of <i>P. fortunei</i> were critical for enhancing soil water infiltration and developing preferential flow in red soil hilly regions. Coarse roots had a greater impact on the development of preferential flow than fine roots, and root volume had a greater influence on preferential flow development than root length and root surface area. This study contributes to a better understanding of the hydrological cycle at the plant-soil interface in red soil hilly regions.

Ultrafiltration Membranes Modified with Reduced Graphene Oxide: Effect on Methyl Green Removal from Aqueous Solution

In this work, three types of ultrafiltration membranes with different characteristics (GR60PP, RC70PP and GR80PP) have been tested for the removal of the dye methyl green. The tests were first carried out with the three membranes without any modification and then with the membranes' surfaces modified with reduced graphene oxide (rGO). The modification was achieved through physical treatment. The CR70PP membrane did not support the modification treatment and was discarded. The other membranes were initially characterized with distilled water tests to study the permeability to the solvent, and later, the permeate fluxes and the values of rejection coefficients were obtained at different working pressures with a fixed dye initial concentration. In addition, SEM images and SEM-EDX spectra of the native and modified membranes were obtained before and after the dye tests. The GR60PP membrane has shown the best results in relation to the modification because it has increased its rejection levels. On the opposite, the GR80PP membrane performs better without surface modification, achieving the highest rejection values and the highest permeate fluxes in its native form.

Comparative Study Between Hysterosalpingo-Contrast Sonography and Hysterosalpingography in Evaluating Tubal Patency at Aminu Kano Teaching Hospital, Kano.

Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital. A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale. The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1). This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.

Determinants of Infertility among Married Couples in a Tertiary Hospital in Bangladesh

Introduction: Infertility is a common issue among married couples in Bangladesh. Infertility is often caused by a combination of multiple factors, and that individual cases of infertility can be complex and difficult to diagnose. Objective: To assess the determinants of infertility among the infertile couples both male and female. Materials and Methods: This prospective observational study was conducted in the Infertility unit, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period from 01.07.2018 to 30.31.12.2021. Five hundred infertile couples were recruited from the out-patient department of infertility unit who came to take treatment for their infertility problem. Results: Mean (± SD) age of the female patients was 27.1 ± 5.2 years ranged between 18-44 years. Mean (± SD) age of the husband of patients was 34.0 ± 5.9 years ranged between 22-55 years. Primary infertility was seen in 59.8% study subjects and secondary infertility was seen in 40.2% study subjects. In our study, most of the women (94%) had below normal (&lt;3 U/L) serum FSH. Most of the women (96%) had below normal (&lt; 2U/L) serum LH. Serum TSH was normal (0.2 – 4.5 mU/L) in 51.0% patients. Majority of the women (60.8%) had above normal (&gt;21 pml/L) serum FT4 level. Most of the women 72.2% had normal serum prolactin level. In male patients, Testosterone level was above normal (&gt;30 nmol/L) in majority of the patients (73.4%). In Hysterosalpigography (HSG), 0.40% had abnormal uterine cavity, 4.2% had septed uterus, 15.2% had bicornuate uterus, 1.0% had unicornuate uterus and 1.6% had endometrial polyp. Hysteroscopy found abnormal uterus in 1.2% of patients, abnormal uterine cavity in 11.4%, abnormal endometrial flakes in 12.4%, abnormal right ostium in 13.0% and abnormal left ostium in 12.6%. Intrauterine adhesion, polyp and submucus fibroid were found in 35.2%, 2.8% and 17.6% respectively. Laparoscopy found abnormal uterus in 3% patients, abnormal right fallopian tube in 33.2%, abnormal left fallopian tube in 34.2%. Also, abnormal right fallopian tube in 37.0% and abnormal left fallopian tube in 37.6%. Pouch of Douglas free was found in 63%. During dye test in laparoscopy, 57.6% patients were found positive. In quality, semen type was found poor (&lt;4%) in majority (61%) of the husbands. Regarding semen count, above normal (&gt;20 million/ml) level was found in majority of the patients (80.8%). Regarding semen quality, majority (96%) had oligospermia (&lt;15 million/ml). In case of rapid linear (RL), normal (50-60%) level was seen in majority of the patients (81.6%). In case of slow linear (SL), below normal (&lt;15%) was seen in majority (64.8%) of the patients. Regarding non-propagative (NP), normal (0-10%) level was seen in most of the (87.8%) patients. In case of morphology of sperms, above normal (&gt;50 million/ml) level was seen in most of the patients (80.6%). Conclusion: This study shows that a significant percentage of both male and female are suffering from infertility. The major causes of male infertility are partly hormonal, structural abnormalities of male genitalia, infection of genital tract, and partly psychological. Causes of female infertility are mostly hormonal, structural abnormalities of the uterus, fallopian tubes, infection of the genital tract and partly psychological.

FORMULATION AND IN VITRO EVALUATION OF A NOVEL MEFENAMIC ACID TOPICAL CREAM

Mefenamic acid (MA) is a Non-Steroidal Anti-Inflammatory Drug (NSAID), which has been established in pharmacologic management of musculoskeletal disorders. This study was designed to formulate and conduct an in vitro evaluation of a novel MA topical cream, which would reduce the gastrointestinal associated toxicities related to oral administration. A concentration of 1-2% of MA was prepared by using a different combination of the excipients. Either ethanol or dimethyl sulfoxide (DMSO) are employed as vehicles for hydrophobic compounds, which are commonly used as solvents. The creams were evaluated by their physical properties, stability studies and addition of an in vitro anti-inflammatory test for mefenamic acid creams. The physical studies include organoleptic test, pH test, spreadability test and dye test while for the stability studies, the creams were tested with accelerated stability studies and microbial growth. MA in DMSO showed better anti-inflammatory effect compared to MA in ethanol in the correlation of results with that of marketed products. In conclusion, this study proved that MA cream can also be a good choice of semi-solid formulation and further studies would be suggested to enhance this cream as a novel choice of formulation to be introduced and marketed by the pharmaceutical industry

FORMULATION AND EVALUATION OF HERBAL CREAM

The aim of the present study was to formulate and evaluate the herbal cream having properties of moistening, nourishing, anti-acne and antiinflammatory effect on the skin using different crude drugs like Azadirachta indica (Neem), Aloe barbadensis (Aloe Vera), Ocimum tenuiflorum (Tulsi). The cream was prepared by using the cream base i.e. bee’s wax, liquid paraffin, borax, methyl paraben, distilled water, rose oil, Aloe Vera gel, aqueous extract of neem and tulsi. The cream was prepared by homogeneous mixing of all the excipients and the herbal extract. By using this method, we have prepared six batches F1, F2, F3, F4, F5, and F6. Formulations were evaluated for different parameters like physical evaluation, irritancy study observation, wash ability, spread ability, PH, Viscosity, phase separation, greasiness observations, dye test, homogeneity, acid value, saponification value. All the six formulations F1, F2, F3, F4, F5, and F6 showed good appearance, PH, adequate viscosity and no phase separation was observed. All the six formulations F1, F2, F3, F4, F5, and F6 were stable and can be safely use on the skin.

Effect of 0.05% chlorhexidine gluconate in water on the hydrophilic inflatable penile prosthesis: biocompatibility, adherence, and dip time.

Rates of infection after inflatable penile prosthesis range from 1% to 3%; however, a new surgical irrigation solution is Food and Drug Administration cleared as antimicrobial wound lavage and appears to be safe for patients and noncaustic during hydrophilic inflatable penile prosthesis (hIPP) dipping and irrigation. To evaluate if 0.05% chlorhexidine (CHG) lavage is caustic to the hIPP coating and if dip adherence is dependent on time. Preconnected hIPP devices were tested at a Coloplast research and development laboratory. The devices were soaked in the 0.05% CHG lavage solution or normal saline for 1, 15, 30, and 60minutes. Subsequently, all parts were dried for 15minutes in a 35 °C oven. A Congo red dye test was performed following a Coloplast-validated and Food and Drug Administration-cleared test method to ensure product reliability. Implants were then visually inspected for deleterious effects as well as dip coverage. In addition, we evaluated 0.05% CHG lavage solution vs previously published hIPP dipping solutions. 0.05% CHG lavage does not appear to damage the hIPP coating, and adherence of this solution is not dependent on dip time. All components of the preconnected hydrophilic IPPs were tested for coating adherence and defects. All tested IPPs achieved a "satisfactory" coating, meaning a uniform coat without flaking or clumping. Furthermore, there were no noticeable caustic effects or differences in coating adherence between the normal saline-soaked control and 0.05% CHG-coated arms with increasing dip time. A review of the literature for 0.05% CHG lavage solutions vs previously published hIPP dipping solutions revealed that it may have some advantages over previously reported antibiotic solutions. This study serves as a foundation to introduce 0.05% CHG lavage to the urologic literature as a potentially new "magic bullet" irrigation. Major strengths of the study are that it is the first study of its kind to address the question of what dip duration should be used and whether it is scientifically reproducible. A limitation is the in vitro model, thus needing validation in a clinical setting. 0.05% CHG does not appear to negatively affect the hIPP coating or differ in adherence with increasing dip time; however, long-term device performance has not been verified.

Predictors of outcomes in patients with repeat surgery for obstetric fistula: a retrospective review

Introduction and hypothesisPredictors of surgical outcomes in patients with an obstetric fistula who have been operated before should be identified in order to guide surgical strategy and optimize counseling of the patient.MethodsThis retrospective study is aimed at identifying predictors of outcomes for repeat surgery in 346 patients who had been operated on before for an obstetrics fistula at the Fistula Care Center (FCC) in Lilongwe, Malawi. Repeat cases were only undertaken by advanced and expert surgeons. The primary outcome was successful anatomical closure, based on a negative postoperative dye test. The secondary outcomes involved urinary continence, based on a patient-reported questionnaire and an objective 1-h pad weight test. Logistic regression models were used to test the predictors for statistical significance.ResultsSuccessful fistula closure was achieved in 288 (83%) patients and continence was achieved in 185 (64%) patients after the first repeat attempt at the FCC. Lack of urethral involvement (Goh classification: proximity to the urethra) was shown to be a good predictor of the outcomes: fistula closure and subjective and objective continence.ConclusionsAbsence of urethral involvement is an independent predictor for successful outcomes in repeat surgery for obstetric fistulas. Even in the hands of an expert surgeon, the risk of another failure in achieving anatomical closure or subjective or objective continence is between 4 and 5 times higher than when the urethra is not involved.

Endoscopic Tubal Restorative Surgeries for Tubal Factor Infertility at a Teaching Hospital in North Central Nigeria: A Preliminary Report of a Prospective Longitudinal Study

Abstract Background: Tubal surgery is an acceptable treatment option for infertility due to tubal factors. However, in the era of assisted reproductive technology, the use of restorative tubal surgery for the treatment of tubal factor infertility has been reduced. Objectives: This study was conducted to determine the incidence of endoscopic tubal surgery, tubal factor infertility, fertility outcomes, and factors that influence successful or favorable outcomes among women with gynecological endoscopic surgeries for tubal factor infertility. Materials and Methods: This is a preliminary report of a prospective longitudinal study of women with endoscopic tubal restorative surgery for tubal factor infertility at a Federal Teaching Hospital in North Central Nigeria between November 9, 2016, and February 12, 2020. Thirty-four women aged 26–42 years who had bilateral tubal blockage before surgeries were analyzed. The primary outcome measure was clinical pregnancy, whereas secondary outcomes were tubal patency, live birth, miscarriage, and ectopic pregnancy rates. Data were analyzed using Statistical Package for the Social Sciences version 26. Data analysis was descriptive and inferential at a 95% confidence interval, P &lt; 0.05 was considered statistically significant. Logistic regression was carried out to determine independent factors for successful fertility outcomes after endoscopic tubal surgery. Results: There were 1534 gynecological admissions among whom 159 (10.4%) had endoscopy surgeries for infertility. Of the 159 women, 37 (23.3%) had confirmed tubal infertility with bilateral tubal blockage on hysterosalpingography and laparoscopy with a dye test. Thirty-four (women who met the inclusion criteria were analyzed and three women who had salpingectomy and bilateral tubal disconnection and those with AMH of &lt;1.0ng/mL were excluded from the study. The mean age was 34.0 ± 5.2 years, and the majority (67.6%) were nulliparous. Peritubal adhesions were the most common tubal pathology seen on laparoscopy. Hysteroscopic tubal cannulation with selective salpingography (41%), salpingolysis (29%), salpingostomy (21%), and fimbrioplasty (9%) were the interventions performed. Bilateral and unilateral tubal patencies were achieved in 58.8% and 32.5%, respectively. The overall cumulative clinical pregnancy rate was 38.2%, out of which 35.3% conceived spontaneously. Live births (LBs) and miscarriage rates are 20.6% and 17.6%, respectively. There was no ectopic pregnancy. Regression estimates showed that lower age (P = 0.029), lesser duration of infertility (P = 0.038), and treatment of other etiological factors at the same setting (P = 0.019) are independent factors for successful fertility outcome after endoscopic restorative tubal surgery. Conclusions: The high rate of spontaneous intrauterine pregnancy and LBs in this study rekindles the hope of natural conception at a low cost among women with tubal factor infertility.

Occurrence of the selected parasites and viral infections in horses and donkeys in Turkey

The present study aimed to investigate the prevalence of certain protozoa (B. caballi, T. equi, T. gondii, Neospora sp.) and viral agents (equine influenza, equine viral arteritis, equine herpesviruses) of equids in Balikesir and its surroundings, in Turkey. Plasma and serum samples were collected from 66 horses and 96 donkeys. Babesia caballi, T. equi and Neospora sp. antibodies were detected with c-ELISA, whereas T. gondii antibodies were revealed by the Sabin Feldman Dye test. Viral agents were detected by the PCR technique. The prevalence rates of the protozoa in horses were 12.12% for B. caballi, 34.84% for T. equi, 9.09% for T. gondii, and 10.6% for Neospora sp. The molecular prevalence of the viral agents amounted to 3.03% for equine influenza virus and 6.06% for equine herpesvirus 5. Equine viral arteritis virus and other herpesviruses (1, 2 and 4) were not detected in any of the samples. The rates of seropositivity in donkeys were 1.69% for B. caballi, 71.87% for T. equi, 90.62% for T. gondii, 23.95% for Neospora sp., 1.04% for equine influenza virus, 0% for equine viral arteritis virus, 3.12% for equine herpesvirus 5, and 0% for other herpesviruses. This study is the first to report the existence of anti-Neospora sp. antibodies in donkeys and the seroprevalence of T. gondii in horses and donkeys in Western Anatolia, Turkey.

Fresh preserved canine amniotic membrane (CAM ) as graft for surgical management of melting corneal ulcer/ keratomalacia in a dog

A four-year-old female Spitz with signs of blepharospasm, ocular discolouration, corneal oedema, gelatinisation of cornea and epiphora from the right eye, for 20 days was presented at Teaching Veterinary Clinical Complex, Pookode. Fluorescein dye test (FDT) revealed intense staining of the cornea. The condition was diagnosed as keratomalacia. Under general anaesthesia, fresh preserved canine amniotic membrane (CAM) transplantation was performed along with a third eyelid flap. Antibiotic eye drops and supportives were initiated. Monitoring of corneal healing was done on the 10th, 20th, 30th and 45thdays, post-surgery. FDT turned negative on day 20. Conjunctival hyperaemia, pannus, corneal opacity and oedema improved postoperatively, resulting in good corneal clarity, fundic reflection and normal vision by day 45. The present article reports the successful management of keratomalacia using CAM as graft.

Carbon Black CB-EDA Nanoparticles in Hepatocytes: Changes in the Oxidative Stress Pathway

Background/Aims: Carbon Black (CB) is the most widely produced and commercially used nanocarbon. Growing evidence links nanomaterials to adverse effects, arising from their large surface area capable of interacting with biological systems. Due to the variety of applications and human exposures to nanoparticles, it is important to assess the potential health risk and understand the underlying mechanisms of their toxicity. The present study aims to investigate the cytotoxic effect of the Carbon black nanoparticle covalently linked to ethylenediamine (CB-EDA) on AML-12 cells, a lineage of murine hepatocytes. Methods: For this, the cells were exposed to CB-EDA for 24h, at different concentrations of the nanoparticle (1, 50, 250, 500 and 1000 μg/mL). Effects on cell viability were evaluated using MTT and neutral red dye tests and analysis of changes in cell morphology. Furthermore, the oxidative profile (levels of reactive oxygen species - ROS and nitrogen - RNS) and inflammatory profile (production of IL-6 and TNF-α) were investigated. Results: The results show that CB-EDA nanoparticle causes a reduction in cell viability at concentrations of 250, 500 and 1000 μg/mL after the exposure period. There was a significant increase in the production of ROS, RNS and pro-inflammatory interleukin TNF-α. Conclusion: The data suggest that CB-EDA nanoparticle has a cytotoxic potential in AML-12 hepatocytes, evidenced by the induction of oxidative stress and secretion of inflammatory cytokines, with a consequent decrease in cell viability.

Dysphagia in Tracheostomized Patients after Long-Term Mechanical Ventilation - Become Sensitive to Reduced Pharyngo-Laryngeal Sensitivity

Independent of the type of critical illness, tracheostomized patients have a high risk of developing a dysphagia. This is potentially life-threatening as it can lead to aspiration and pneumonia. It is therefore essential to perform swallowing diagnostics by means of a bolus dyeing test and/or FEES before oral feeding. Since a physiological airflow through the larynx and adequate subglottic pressure are key components of an effective swallowing act, oralisation should be avoided as far as possible with a blocked tracheal cannula.