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Objective(s): Design and construction of biocompatible and biodegradable scaffolds are among the main goals of tissue engineering. Recently, use of nano-hydroxyapatite as a bioactive bioceramic agent with high similarity to the mineral phase of the human bone tissue, in combination with biodegradable polymers and implant coatings has attracted the attention of researchers in the field of biomaterial sciences. The present study aimed to assess the differentiation of bone marrow stromal cells (BMSCs) in osteoblast-like cells on the chitosan/polyethylene oxide (PEO)/nano-hydroxyapatite scaffold in mature rats. Materials and Methods: Chitosan and PEO solution with the weight ratio of 80:20 and 70:30 were prepared, and 2% weight of nano-hydroxyapatite was added. Nanofibers were prepared using the electrospinning method, and the morphology was studied using scanning electron microscopy (SEM). Afterwards, the BMSCs of mature rats were cultured on nanofibers and differentiated by adding a differentiation medium. The survival of the differentiated cells was evaluated at the end of the first, second, and third week using acridine orange staining, and the morphology of the differentiated cells exposed to nanofibers was assessed using SEM. Results: The mean diameter of the nanofibers with the ratio of 80:20 was 150±17 nanometers. The differentiation of BMSCs into the osteoblast-like cells on nanofibers was confirmed using Alizarin red staining. The results indicated a significant decrease in the survival of the differentiated cells in the nanofiber groups by the end of the third week of differentiation compared to the control samples. Conclusion: According to the results, BMSCs could be differentiated into osteoblast-like cells in the presence of the chitosan/PEO nanofibers containing nano-hydroxyapatite. [ABSTRACT FROM AUTHOR]

Background: Effective malaria control strategies require an accurate understanding of the epidemiology of locally transmitted Plasmodium species. Emerging evidence indicates that migrants from malaria endemic regions are at risk of delayed presentation of Plasmodium spp. and malaria infection. Cases Report: We reported a case of P. vivax malaria occurring after arrival in Iran. Patient was originally from Iraq. A 48-year-old male patient who was hospitalized with fever attacks, chills, and headache after arriving from Iraq to Tehran. Conclusion: In this patient, new prevention and screening strategies should be studied and blood safety policies adapted. Thus, ultimate elimination of malaria in Iran will require national malaria control program to adopt policy and practice aimed at all human species of malaria since neighbor country are still face to problem to control of malaria. [ABSTRACT FROM AUTHOR]

Objective (s): Several methods have been proposed for repairing defects and damages, one of which is cell therapy. Bone marrow stromal cells seem to be suitable for this purpose. On the other hand, many biometric materials are used to improve and correct the defects in the body. Nanofibers are widely used in the medical industry, especially in tissue engineering, as scaffolds in wound healing and wound dressing. Chitosan/ polyethylene oxide nanofibers can be a suitable replacement for routine wound coverages. Hence, this study was conducted to present a combination of these methods. Materials and Methods: Chitosan/polyethylene oxide nanofibers and thin films of chitosan were produced and optimized by electron microscopy, on which the bone marrow stromal cells were then cultivated. Interactions between the cells and these biomaterials were investigated through viability, morphology, immunocytochemistry and electron microscopy of cells after 6 days. All data were analyzed using Student's t-test and one-way ANOVA tests in SPSS version 16. P<0.05 was considered significant. Results: It seems that the high viscosity of chitosan prevents the formation of nanofibers, while chitosan/polyethylene oxide solutions with 80/20 and 90/10 ratios produce perfect, regular, bead free and non-toxic nanofibers with average diameter of 240±10 and 220±10 nm, respectively. The results of immunocytochemistry and viability showed that the cells had relatively high proliferation on the thin chitosan membranes, while the results of the electron microscopy showed that the morphology of cells was better on the nanofibers than on the thin membrane of chitosan. Conclusion: Since bone marrow stromal cells were grown well on chitosan-nanofibers, each of them alone was used in the therapeutic methods. It is better to consider a combination of two methods as the treatment method, especially in tissue engineering and cell therapy. [ABSTRACT FROM AUTHOR]

Background: Intestinal parasitic infections are major causative agents of wildlife health complications among different parts of the world. This study aimed to investigate the gastro-intestinal parasites in feces of the zoo animals based on parasitological and morphometric criteria. Methods: One hundred fresh fecal samples were collected from 35 species of animal lived in Eram park zoo, Tehran, Central Iran during Oct 2015 to Jun 2015. All collected samples were examined by microscopic observation following direct wet mount preparation (normal saline and Lugol's iodine), formalin-ether concentration, and permanent staining. The morphometric aspects of the recovered eggs were surveyed with the aid of Camera Lucida (×400). Results: 65.7% (23/35) of zoo animal species were infected with intestinal parasites. The superfamily Trichostrongyloidea (6/16) and Strongylus sp. (16/4) were the most prevalent helminthic infections, while Blastocystis sp. (6/14), Entamoeba cyst (3/14) and Eimeria sp. (3/14) were the common protozoan parasites. For the first time, Bivitellobilharzia nairi egg was identified an elephant at Iran. Intestinal parasitic infections were apparently circulating among animals of the Eram park zoo. Conclusion: Identified parasitic infections can consider as a threatening source to visitors and workers' health that have contact with animals or their feces. Therefore, the effectual preventive strategies should be addressed to determine the risk factors, mechanisms of cross-transmission of parasite, the importance of applying the hygienic practices and well adjusting deworming programs for the animals, zoo workers and visitors. [ABSTRACT FROM AUTHOR]

Background: Toxoplasmosis is one of the world's most common infections in human and other warm-blooded vertebrates and has the most extensive universal spread. The purpose of this study is determining the seroprevalence of human Toxoplasma gondii infection, in the military personnel and their families referred to Baqiyatallah hospital, 2011-2015. Materials and Methods: In this cross-sectional study, the serum of 3370 person contain 770 men and 2600 women attending the laboratories were selected and after completing the questionnaires and also by implementing Chemiluminescence method, these serums were examined for the presence of IgM and IgG immunoglobulins of the Toxoplasma gondii. Results: The results were analyzed using the chi-square test. They showed that there were no statistical relationships between the prevalence of IgG and gender in 2011, 2013, (P>0.05) but there were significant relationships between them in 2012, 2014 and 2015 (P<0.05), also there were no statistical relationships between the prevalence of IgM and gender in all years (P>0.05). The results showed that there were statistical relationships among IgG and age (P<0.01) but there was no statistical relationships between IgM and age in all cases (P>0.05). Conclusion: The results showed high prevalence of Toxoplasmosis in the military personnel and their families in Baqiyatallah hospital. The prevalence of IgG was somehow in the range and positive IgG titer was somewhat higher than what was reported in other studies in the North-West of the country; this could be partly due to the sensitivity and specificity of Chemiluminescence method compared to other methods of serology in diagnosis of Toxoplasmosis. [ABSTRACT FROM AUTHOR]

Objective(s): Various methods for repairing bone defects are presented. Cell therapy is one of these methods. Bone marrow stromal cells (BMSCs) seem to be suitable for this purpose. On the other hand, lots of biomaterials are used to improve and repair the defect in the body, so in this study we tried to produce a similar structure to the bone by the chitosan and hydroxyapatite. Materials and Methods: In this study, the solution of chitosan-nanohydroxyapatite-polyethylene oxide (PEO) Nanofibers was produced by electrospinning method, and then the BMSCs were cultured on this solution. A piece of chitosan-nanohydroxyapatite Nanofibers with BMSCs was placed in a hole with the diameter of 1 mm at the distal epiphysis of the rat femur. Then the biomechanical and radiographic studies were performed. Results: Biomechanical testing results showed that bone strength was significantly higher in the Nanofiber/BMSCs group in comparison with control group. Also the bone strength in nanofiber/BMSCs group was significant, but in nanofiber group was nearly significant. Radiographic studies also showed that the average amount of callus formation (radio opacity) in nanofiber and control group was not significantly different. The callus formation in nanofiber/BMSCs group was increased compared to the control group, and it was not significant in the nanofiber group. Conclusion: Since chitosan-nanohydroxyapatite nanofibers with BMSCs increases the rate of bone repair, the obtained cell-nanoscaffold shell can be used in tissue engineering and cell therapy, especially for bone defects. [ABSTRACT FROM AUTHOR]

The removal of methylene blue by activated carbon of corn husk by ZnCl2 activation (CHACZ) was investigated in the present study. Adsorption studies were performed by batch experiments. The effect of pH, initial dye concentration, adsorbent dose, the particle size of CHACZ, agitation speed, temperature, and contact time was explored. The equilibrium adsorption data were analyzed using two widely applied isotherms: Langmuir, Freundlich. Best fits were found to be Freundlich isotherm. Langmuir adsorption capacity (Qm) in 298, 308, and 318K is 462.96, 546.45, and 662.25 mgg-1. The amount of RL indicates that CHACZ has a favorable adsorption. Maximum MB removal was observed at pH 4.0. The results indicate that CHACZ is an efficient adsorbent for removing dye from wastewater. [ABSTRACT FROM AUTHOR]

Expansive cement mortar can be used in conjunction with a Type I cement mortar to develop a composite beam, which after curing will have residual ·compressive stresses on the tensile surface which can result in significantly increased flexural strength. The magnitude of the increased flexural strength, for a particular beam geometry and a given expansive cement, depends on the relative thicknesses of the layers of the two mortars. [ABSTRACT FROM AUTHOR]

• Paper deals with the coordinated control of DFIG WT and microturbine in a DC microgrid feeding constant power load (CPL). • DFIG WT depending on the load demand and wind speed operates in the power control mode or load following mode. • Paper develops control structures for the DFIG WT in the dc microgrid at both operation modes. • Studies show that in the load following mode and under high penetration of CPLs, the study system may become unstable. • Control structure of DFIG WT is modified to efficiently stabilize the system under high CPL penetration. This paper deals with the coordinated control of DFIG wind turbine system and microturbine in a DC microgrid system feeding constant power load (CPL). The DFIG stator and rotor are connected to the DC grid through diode rectifier, buck converter, and frequency converter, respectively. The DFIG wind system depending on the load demand and wind speed operates in the power control mode or load following mode. In the power control mode, the DFIG wind system injects the available wind power to the grid and microturbine sets the DC bus voltage to its reference value. In the load following mode, the DFIG wind system regulates the DC bus voltage to a constant value, and the power injected by the microturbine decreases to a negligible value. Studies show that in the load following mode and under high penetration of CPLs, the study system may become unstable. Hence, this paper, first, develops control structures for the DFIG wind system in the DC microgrid at both operation modes, and then control structure of the DFIG wind system is modified to efficiently stabilize the system under high CPL penetration. Next, performance and stability of the system are examined analytically and by time domain simulations. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Giant cell tumor of bone (GCT) is a rare neoplasm which often presents as a lytic lesion in the epiphyseal region of long bones and which are usually accompanied by pain, swelling, and restricted movement. Giant cell tumor of bone (GCT) is a rare neoplasm that affects individuals in their third and fourth decades of life. Clinically, it often presents as a lytic lesion in the epiphyseal region of bones, notably the distal femur and proximal tibia. Radiologically, GCT appears as a distinct lytic lesion in the epiphyseal region. Histopathologically, GCTs are composed of mononuclear cells, macrophages, and multinuclear giant cells, indicative of osteoclastogenic stromal tumors. A 37‐year‐old man presented with left wrist pain, swelling, and restricted movement persisting for a year, worsening over the last 7 months. Radiographic assessments revealed a distal radius bone mass involving the radiocarpal joint. Biopsy confirmed a GCT with extension into peripheral muscle. PET/CT scan showed localized pathology without metastasis. Histopathologically, GCT exhibited multinucleated giant cells, spindle cells, and aneurysmal bone cyst‐like regions with coagulation necrosis. Surgical resection involved en‐bloc removal and reconstruction with a non‐vascularized radius bone graft. Postoperatively, the patient showed no complications at the one‐year follow‐up, suggesting successful intervention. [ABSTRACT FROM AUTHOR]

Summary: This paper analytically deals with the transient behavior evaluation and crowbar hardware design for the low voltage ride‐through (LVRT) capability enhancement in doubly fed induction generator (DFIG)‐based wind turbines (WTs). The paper indeed answers the following question analytically. "What are the main criteria for choosing the crowbar resistance?" It is shown that the value of the crowbar resistance affects both the peak values and oscillations of the DFIG transient response. Therefore, the paper first analytically investigates the rotor dynamics with the crowbar hardware during the voltage dip, and then develops analytical expressions for the crowbar resistance design to meet the LVRT requirement. It is shown that selection of the crowbar resistance higher than the maximum value may deteriorate the DFIG LVRT performance. Next, contribution of the DFIG to the fault current by using the crowbar is analytically studied. Then, the impact of crowbar resistance on the damping of the DFIG transient oscillations is examined by the modal analysis and phase plots of the stator flux. At the end, the concept of rotor active impedance is introduced, the LVRT capability of the DFIG is evaluated, and the DFIG transient responses under different crowbar resistances are investigated and compared. [ABSTRACT FROM AUTHOR]

Summary: This paper first deals with the sensorless estimation of shaft torsional torque, and turbine and generator speeds in permanent magnet synchronous generator (PMSG) based wind turbines (WTs). In this way, cascade observers, comprising the inner and outer ones, are introduced for estimation of the turbine and generator speeds and shaft torsional torque. Then, by using the estimated speeds of the turbine and generator, a new sensorless active damping compensator is proposed that is efficient for suppression of WT torsional vibrations. The proposed sensorless compensator operates based on the difference of the turbine and generator speeds and provides sufficient damping even under the drive train model uncertainty. The conventional approaches, used for damping of WT torsional oscillations, mainly do based on the generator speed feedback and with using the band pass or high pass filters. However, the performance of the conventional approaches, because of existence of the band pass/high pass filters, may be failed under the drive train model uncertainty because the drive train resonant frequency changes under the drive train model uncertainty. At the end, the performance of the proposed sensorless compensator is compared with that of the conventional damping approach with/without considering the drive train uncertainties. [ABSTRACT FROM AUTHOR]

Doubly fed induction generator (DFIG) has been widely applied in wind farms. Meanwhile, DFIG control at high wind speeds has become an important issue. In this regard, the main task of pitch angle control loop is too important by the wind speed increase above the middle speeds (e. g. 12 m/s) to limit DFIG active power and rotor speed and to control the machine performance. In this study, a fractional order PI controller (FOPI) is designed and applied for the pitch angle compensation control loop to improve the DFIG performance at the high wind speed of 18 m/s. Due to using the fractional order coefficient as an extra control variable in the FOPI controller function in comparison with the PI controller, a preferable control scheme would be realized in the pitch angle control by the wind speed increase to high values. In this regard, the various simulation results for monitoring the active power and rotor speed are obtained in the multi machine test system including the DFIGs considering high wind speed operating mode via using MATLAB/SIMULINK software. In addition, different kinds of transient faults are considered to evaluate the performance of the proposed FOPI controller, instead of the conventional PI controller. The results validate the advantage of using the FOPI control scheme in the pitch angle control loop for promoting the DFIG active power and rotor speed profiles. [ABSTRACT FROM AUTHOR]

This article has focused on designing and applying the fractional order [PI] (FO[PI]) controllers in the rotor side converter (RSC) of a doubly-fed induction generator (DFIG) wind turbine in the wind farm connected to a weak grid. To design the controllers, an analytical approach is developed to ensure the frequency domain specifications. The proposed fractional order controllers are simultaneously applied in the internal and external control loops of the RSC to improve DFIG active power, rotor speed and rotor current profiles by occurring various balanced and unbalanced transient faults. Different simulation results are obtained to verify the efficacy of the proposed method at both middle and high mean wind speeds. Meanwhile, the uncertainty in the grid parameters including the short circuit capacity (SCC) and X/R ratio is surveyed by reducing these parameters to show the superior performance of FO[PI] controllers in comparison with PI ones. [ABSTRACT FROM AUTHOR]

This paper deals with the modeling and control of the grid-connected photovoltaic (PV) inverters. In this way, the paper reviews different possible control structures that can be used for grid-connected inverters and then examines their capabilities. The controllers that are used are classic PI controllers and inverter is working in current control mode. A low pass filter is used for interconnection of inverter to the grid which is mainly LCL filter and depending on control way, there are four control strategies. In this paper, at first, control design methodology for each strategy is proposed and then performance comparison between these strategies is carried out. The performance analysis is carried out from different point of view such as grid voltage disturbance rejection and stability under different grid short circuit levels. The inverter output impedance is used as a criterion for inverter performance evaluation which has an important role in grid voltage disturbance rejection and system stability in different grid short circuit levels. Finally the best strategy will be introduced by using the simulation results in Matlab/Simulink software. [ABSTRACT FROM AUTHOR]

Objective: To assess the results of endoscopic ureterocele treatments as well as the effects of ureterocele location (intravesical vs. ectopic) and anatomy (single vs. duplicated system) on treatment outcomes., Material and Methods: Following the Systematic Reviews and Meta-Analyses (PRISMA) standards, several medical databases as well as Google Scholar were searched comprehensively. Studies describing secondary operation outcomes for endoscopic transurethral incision and puncture were included. Studies were required to compare patients according to ureterocele location (intravesical or ectopic) and anatomy (single or duplex system) or preoperative reflux. Meta-analysis was conducted using Comprehensive Meta-analysis (CMA) software., Results: A total of 83 studies entered this systematic review consisting of 3022 patients. According to the meta-analysis of 16 studies, the risk ratio (RR) of reoperation after ureterocele incision was significantly higher in patients with ectopic vs. intravesical ureteroceles (RR: 2.42; 95% CI: 1.89-3.11; P < 0.001; I 2 : 14.89%). Also, a higher reoperation rate was reported in patients with duplex system ureteroceles (DSU) vs. single system ureteroceles (SSU) with little heterogeneity based on 9 studies. (RR: 2.50; 95% CI: 1.60-3.91; P < 0.001; I 2 : 13.83%)., Conclusion: Our results showed that ectopic ureteroceles and duplex systems are associated with higher reoperation rates after endoscopic procedures., Competing Interests: Conflicts of interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Thumb distal amputation refers to the loss of a portion of the thumb at or near the tip, which can be caused by various injuries such as crush injuries, lacerations, or avulsions. Several surgical methods can be used to repair thumb distal amputations, including composite graft, flap reconstruction, replantation, and amputation revision. In this case report, we describe a successful surgical procedure performed on three healthy men (19, 26, and 44 years old) who suffered a sharp amputation of their left and right hands thumb. In one case initial fixation of the amputated part was performed by a general orthopedic surgeon as a composite graft, two other cases were referred us without any procedure. The procedure involved irrigation and minimal debridement and deepithelializing the amputated part and fixation it with one or two 1.5 mm steinman pins and repairing the nail bed with7/0 absorbable sutures. An adiposofaciocutaneous flap from the index finger was used to cover the pulp of the thumb and the nail bed, while a full-thickness grafts from the same wrist in one case and medial part of ipsilateral arm in others were used to repair the defect on the dorsal side of the index finger. The wound was dressed, and the sutures were removed after two weeks. The base of the flap was detached from the index finger after three weeks, and the kwires were removed after six weeks. The flap and graft were successfully taken, except for a small part of the tip of the thumb. Two years after the operation, in two patients and 3 months in whom was operated recently, all the patient's thumbs had a reasonable shape and length with minimal nail deformity. The use of an index finger based adiposofaciocutaneous flap and full-thickness graft in these cases allowed for successful reconstruction of the thumb and, improving both function and appearance., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 The Authors.)

Key Clinical Message: The modified nail folding approach, a new surgical technique, has been shown to be safe and effective for the treatment of subungual glomus tumors, providing clinicians with a new treatment option for patients with this condition., Abstract: Glomus tumors (GTs) are rare benign tumors that originate from the glomus body in the skin of the fingertips, toes, and nail beds. GTs are more prevalent in women than in men and can occur sporadically or as part of an inherited condition known as multiple GTs. The exact cause of GTs is unknown, but it is believed that mutations in the cells of the glomus body contribute to their development. In this study, we present the efficacy of a novel surgical technique called the modified nail folding approach for treating subungual GTs. We report a case series involving 17 patients who underwent the nail folding approach for surgical removal of subungual GTs. The primary objective of this article is to provide evidence supporting the safety and effectiveness of this technique. Additionally, we aim to introduce clinicians to a new, secure, and efficient treatment option for patients with subungual GTs., Competing Interests: The authors declare that there is no conflict of interest., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Background: A temporary loop ileostomy is one of the most common methods for the prevention of anastomotic leakage in rectal cancer patients who underwent low anterior resection. However, the optimal timing of loop ileostomy reversal remains unknown. The main objective of this study was to evaluate the debilitating complications caused by early closure of ileostomy in comparison with late closure in rectal cancer patients., Design: A randomized, controlled, unblinded, and monocentric trial., Methods: A total of 104 rectal cancer patients were randomly assigned to the case group of early closure of ileostomy (n = 50) and the control group of late closure of ileostomy (n = 54). This trial was undertaken in a single colorectal institution, a university-affiliated teaching hospital in Tehran, Iran. Randomization and allocation to the trial group were conducted by using variable block randomization based on quadruple numbers. The primary endpoint of this trial was determined by the complications of early ileostomy closure versus those of late closure in rectal cancer patients who had undergone low anterior resection. In early closure, loop ileostomy is reversed 2-3 weeks after the first two courses of adjuvant chemotherapy, while in late closure, the ileostomy is reversed 2-3 weeks after the last course of adjuvant chemotherapy., Results: Follow-up of 1 year demonstrated a reduction in the risk of complications and an improved quality of life in patients with rectal cancer following low anterior resection and chemotherapy (neoadjuvant and adjuvant) in the case group but did not reach a significant difference (p = 0.555). In addition, there was no significant difference in perioperative outcomes, such as blood loss, operative time, readmission, and reoperation; also, no statistically significant differences were reported between the groups in patients' quality of life or LARS score., Conclusion: In summary, it seems that early closure of ileostomy is not better than late closure in improving patients' quality of life with rectal cancer following low anterior resection and chemotherapy (neoadjuvant and adjuvant); no statistical difference was observed for reduction of risk of ostomy complications. Thus, neither of these methods (early closure versus late closure) is superior to the other, and controversy still exists., Trial Registration Number and Date of Registration: IRCT20201113049373N1., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Various techniques have been developed for the rapid control of bleeding as a potential surgical complication. Research shows that the Surgicel has a significant effect on reducing bleeding in most surgeries; however, in our experimental observations on patients undergoing open prostatectomy, not only no significant reduction was seen in the amount of bleeding, but in some cases, Surgicel led to infection. Therefore, in this study, the effect of the Surgicel on infection and bleeding in open prostatectomy was investigated., Materials and Methods: Thirty patients undergoing open prostatectomy were randomly divided into two groups. To control bleeding after suturing the bladder neck, the Surgicel was installed in the first group, while it was not in the second group. Hemoglobin, hematocrit, PT, PTT, INR, bleeding rate, and postoperative complications were evaluated in all patients., Results: In the studied groups, hemoglobin level and hematocrit percentage before surgery and on the first and second days after surgery, along with coagulation status, were compared in terms of PT, PTT, and INR. There were no significant differences between the studied variables and baseline variables., Conclusion: The present study revealed that the Surgicel in open prostatectomy was ineffective in controlling bleeding and can lead to infection., Competing Interests: None., (AJCEU Copyright © 2023.)

Introduction: Considering that the use of aromatase inhibitors in the treatment of infertile men is a new approach and obesity in men is one of the factors affecting infertility, we decided to compare the effect of combined therapy of Human chorionic gonadotropin (HCG) and Letrozole and either of the two methods alone on the spermogram parameters in obese men with idiopathic infertility., Materials and Methods: This clinical trial study was performed with the participation of 15 infertile and obese men from 2018 to 2019 in Tabriz (infertility clinics); Patients were randomly divided into three groups; The first group received treatment with Letrozole 2.5 mg daily alone, the second group received treatment with HCG ampoules at a dose of 5000 units twice a week, and the third group received combination therapy with HCG ampoules at a dose of 5000 units twice a week and letrozole tablets at a dose of 2.5 mg daily; The results of testosterone and sperm tests before and after the intervention were evaluated by t-test and linear regression tests in SPSS21 software. A p -value less than 0.05 was considered significant., Results: There was no statistically significant difference between semen indices and hormones studied before the intervention (P < 0.05), while after the intervention there were statistically significant differences between all variables compared to those before the intervention (P < 0.05); Also, the rate of change in the third group was much more favorable than the other two groups., Conclusion: The combination of HCG ampules with letrozole tablets compared to the use of these drugs alone improved sperm count, sperm motility, and sperm morphology., Competing Interests: None., (AJCEU Copyright © 2022.)