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Abstract Background During surgical planning for the excision of odontogenic cysts and tumors, surgeons should consider choosing the appropriate endoscopic approach to reach all parts of the maxillary sinus and cyst walls during its enucleation. Using the endoscopic trans-nasal approaches results in less than one-third of the maxillary sinus being reached regardless of antrostomy or angled instruments used. Also, the expansion process and involvement of maxillary sinuses in odontogenic cysts and tumors are variable, adding more difficulties during excision. This study aimed to assess the expansion process of large benign odontogenic cysts and tumors involving nasoantral regions and adaptability to different endoscopic approaches for enucleation. Six patients were included in this case series study. Preoperative panoramic views plain film radiography, and computed tomography scans were obtained. Lesion characteristics, relation to teeth origin, the nose, and maxillary sinus wall displacement, location of lesions about typical vertical and horizontal nasomaxillary constructions, and associated inflammation of the paranasal sinuses were evaluated. Three surgical approaches were tailored, allowing viewing and endoscopic enucleation. Results Four periapical (radicular) cysts, one ameloblastoma, and one calcifying epithelial odontogenic tumor, ranging in size from 3 to 5 cm, were enucleated endoscopically in patients aged 15–40 years. Intra-sinus expansion of the cyst and lesion level above the nasal floor allowed endoscopic enucleation using wide middle meatal antrostomy in 1 (17%). Lesions localized to the anterior wall and the nasal process of the maxilla permitted endonasal minimal rhinotomy approach in 1 (17%). Central lesions, cyst extension below the level of the nasal floor, and lateral wall expansion with or without anterior maxillary wall scalloping had adequate exposure using a minimal sublabial approach in four patients (67%). Together with its role in complete enucleation, endoscopy allowed associated rhinosinusitis surgical treatment in five patients (83%). Conclusion Tailoring surgical approaches to the expansion process allowed endoscopic enucleation of large odontogenic cysts/tumors without wall remnants. The integrity of the Schneiderian membrane was preserved, protecting the critical surrounding structures.

Abstract Background This study aimed to validate the translation of the Sinus and Nasal Quality of Life Survey (SN-5) into Arabic (SN-5a) in pediatric chronic rhinosinusitis (CRS) patients. A prospective cohort randomized controlled study was conducted on 129 children with CRS and 100 age- and sex-matched healthy children. The questionnaire was translated into the Arabic language with cross-cultural adaptation. Caregivers answered the questionnaire during their first visits and after 1 week; to assess test–retest reliability and after 2 weeks of medical treatment to test the questionnaire’s ability to detect changes in patients’ symptoms. The responses of the patients and control groups were compared to assess the external validity. Results The SN-5a showed internal consistency and reliability, with Cronbach’s alpha value being 0.69. Item–item and item–total correlation analysis showed adequate construct validity with a highly significant negative correlation between the SN-5 questionnaire items and visual analog scale (VAS) (p < 0.001). There were highly significant positive correlations between items of the questionnaire in the 1st and 2nd visits at 1 week (p < 0.001). A highly significant difference between the case and control groups had been shown for all SN-5a items (p < 0.001). Two weeks after treatment, there were large changes in all the questionnaire items between the first and last visits (effect size > 0.8 for all). Conclusion The translated SN-5a exhibited adequate construct validity, internal consistency, test–retest reliability, and external validity with quite enough ability to assess the longitudinal changes of the disease.

This study aimed to investigate the feasibility of using geopolymer paste (GP) as an adhesive agent for (i) anchoring steel bars in concrete substrates, (ii) repairing concrete, and (iii) repairing limestone and granite masonry blocks commonly found in historic buildings. In this investigation, seven cement-free GP mixes were developed with different combinations of binder materials (slag, silica fume, and metakaolin). The mechanical properties, adhesive performance, and production cost of the developed GP mixes were compared to those of a commercially epoxy adhesive mortar (EAM). The results obtained from this study indicated that the use of GPs enhanced the bonding between steel bars and concrete substrates, achieving bonding strengths that were 19.7% to 49.2% higher than those of control specimens with steel bars directly installed during casting. In concrete repairs, the GPs were able to restore about 60.6% to 87.9% of the original capacity of the control beams. Furthermore, GPs exhibited a promising performance in repairing limestone and granite masonry blocks, highlighting their potential suitability for masonry structures. The best adhesive performance was observed when a ternary binder material system consisting of 70% slag, 20% metakaolin and 10% silica fume was used. This combination, compared to the investigated EAM, showed comparable adhesive properties at a significantly low cost, indicating the viability of GPs as a cost-effective, eco-friendly adhesive agent.

Although pitch-derived carbon foam (CF) is not new, but the progress for enhanced thermal, mechanical, and catalytic dye degradations need to be explored. Numerous works were performed to improve the structural morphology and properties of the CFs by dispersing various additives. But mostly it was noticed that such additives enhanced one aspect of the CFs at the cost of other ones. In this work, various additive loadings of the functionalized graphene oxide (FGO), and functionalized titanium dioxide (FTiO2) were synergistically dispersed into the CF matrix via facile pyrolysis for the preparation of CF/FGO and CF/FGO + FTiO2 hybrid composites to improve the structural morphology and properties of the CFs. Functionalization of the graphene oxide (GO) and titanium dioxide (TiO2) nanoparticles (NPs) was performed for the purpose to decrease the possible aggregations, and enhancing the compatibility and interaction between the additives and the CF matrix. A total of seven CF composites including pure CF were synthesized and explored for their structural, thermal, mechanical, and catalytic dye degradation performances. The microstructural investigations revealed that cellular morphology, pore size, shape, and porous homogeneity of the CF composites were significantly improved after the FGO and FTiO2 loadings. The thermal and mechanical behaviors revealed that as the additives loading of the FGO and FTiO2 are increased, the thermal and mechanical responses of the CF composites are significantly improved. The maximum thermal conductivity of 27.9 W/m K was revealed by 4wt.% CF/FGO + FTiO2 hybrid composite. Similarly, the optimum compressive strength of 15.7 MPa, specific compressive strength of 3.5 10 m3, excellent stress–strain, and improved Young's modulus of 42.2 MPa was shown by 4wt.% FGO + FTiO2 hybrid composite. The catalytic activity was evaluated by degrading orange II dye in an aqueous medium under ultraviolet (UV) light irradiation. The TiO2-containing composite was found to be active and the sample with 4wt.% CF/FGO + FTiO2 hybrid composite achieved a significant 78.9% degradation of the dye within just 80 min.

Based on the versatile nature and applications of Carbon foam (CF), up to now many attempts were performed to improve the structure and properties of CF by incorporating various additives in the CF matrix. But these additives improved one property on the cost of another ones. Herein, we have synergistically incorporated multi-walled carbon nanotubes (MWCNTs) and graphene oxide (GO) with varying loadings as additives in the CF matrix via direct pyrolysis to achieve all the desired properties. Seven different types of CF composites including pure CF were prepared and their effect on the structure, mechanical, thermal, electrical and catalytic characteristics has been reported. The results revealed that after the inclusion of MWCNTs and GO contents, the microstructural performance of CF samples was amazingly improved. Additionally, it was observed that mechanical, thermal, electrical and catalytic behaviors of the CF samples were significantly enhances by the increase of nanohybrids. The compressive strength and Young's modulus reveals their optimum limits up to 19.3 and 57.4 MPa respectively on 2 wt.% MWCNTs-GO additive loadings. Similarly, the greatest thermal and electrical conductivities of 30.92 W/m. K and 27.4 × 103 S/m were showed by CF samples having 2 wt. % MWCNTs-GO loadings. Whereas, the decolorization activity of the CF and their nanocomposites were tested against methyl orange dye and it was observed that the sample with enhanced MWCNTs and GO have good decolorization activity and much sustainable than other samples. The 4% CF/MWCNTs-GO decolorized about 76% MO dye under exposure to UV light within 60 min. The decolorization of MO dye increases with increasing nanocomposite dosage and decreasing initial dye concentration.

The monoclinic CuO has a natural tendency to grow into sheet-like structures from alkaline solutions without the need for any specialized reaction conditions or structural directing agents. We demonstrate this growth habit of CuO by heterogeneously nucleating it onto Ni foam substrate from just the ammonical solutions of Cu salts. The growth kinetics were found to be fast and, dense, interlaced thin films with an average sheet width of 20 nm can be grown by simply controlling the degree of supersaturation of the solution. Strongly adhered films with thicknesses up-to 5 μm were deposited from three different Cu salt solutions. Due to faster growth kinetics, growth time has little effect on both the film and nanosheet thickness. Detailed structural and compositional characterizations of the CuO nanosheets were made using FESEM, HRTEM, SAED, XRD and, XPS. The utility of the grown CuO nanosheets is demonstrated as a ready to use electrode for electrochemical supercapacitors. Specific capacitance in excess of 498 F/g was calculated from the Galvanostatic charge–discharge measurements collected at a current density of 0.5 A/g.

Heavy metal contamination is a major environmental issue worldwide and a significant public health risk. However, developing environmentally sustainable and technically viable solutions or adsorbents for treating water contamination caused by heavy metals is urgently needed. In this work, an eco-friendly approach of obtaining a new composite material called ZrO2/GO that was prepared from the synthesized nano zirconium oxide (ZrO2) and graphene oxide (GO) prepared from spent carbon rods in zinc carbon batteries. ZrO2/GO was analyzed by XRD, SEM, BET, EDX, and FTIR to learn more about its composition and structure. The batch approach determined the optimal sorption conditions, including pH4, 50 mg ZrO2/GO, 150 mg/L U(VI), and 50 min of sorption time. ZrO2/GO was found to have a 128 mg/g sorption capacity. The Langmuir and 2nd-order kinetic equations can be exploited to elucidate the adsorption approach with reasonable accuracy. Since sorption is exothermic when it occurs naturally, thermodynamic restrictions were also envisioned. ZrO2/GO retains over 92% heavy metal ions (VI) removal efficiency even after 7 cycles. ZrO2/GO shows assurance as a potent sorbent material to extract hexavalent heavy metal ions and adsorption capacity from massive solution volumes.

Abstract Background Children with hemophilia have serious, recurrent joint bleeding that causes disabilities. Regular factor VIII concentrate replacements have not yet completely stopped intra-articular subclinical hemorrhages and permanent joint damage. The prevention of joint damage requires the early detection and management of this hemorrhage. Neoangiogenesis is crucial in the development of synovitis after recurrent hemophilic joint bleeding. This study assessed the level of serum Vascular endothelial growth factor A (VEGF-A) as a vascular biomarker in children with hemophilia A to determine its possible role as a diagnostic biomarker for hemophilic arthropathy. Result A case–control study with 30 male children who had hemophilia A and 30 healthy controls was conducted. Patients had significantly higher serum VEGF-A levels than the control group (specificity was 70.0% and sensitivity was 83.3%). Hemophilia severity and Hemophilia Joint Health Score had a significant positive correlation with VEGF-A. Conclusion Children with hemophilia A had significantly higher levels of VEGF-A in their serum. Additionally, VEGF-A had a significant positive correlation with Hemophilia Joint Health Score as well as the severity of the disease. In children with hemophilia A, VEGF-A can be used as a marker for early hemophilic arthropathy detection.

Nanodiamond (ND) is becoming the core center of interest for many researchers due to its immense utilization in different fields of science. The extraordinarily unique attributes provided by NDs include biocompatibility, easy production, chemical inertness, rich surface chemistry, small size, and fluorescence resistance. In biomedical sciences, all these characteristics uplift the standards of ND particles. Recent studies on the biomedical side have been found to strengthen its significance ever since ND tested positive for utilization in diagnostics and drug delivery. In addition, NDs have been proven beneficial in the manufacturing of biodegradable surgical instruments, scaffolds for tissue engineering, and drugs to eliminate resistant microbes and viruses. Genetic materials are also delivered to the center of the nucleus with the aid of ND particles. In this review, we have discussed in detail all the benefits of NDs, their applications in sensors, ND-blood interactions, blood-contacting, orthopedics, anti-cancer agents, antimicrobial agents, and drug/gene delivery. The importance and significance of the purification, synthesis, processing, and surface functionalization of NDs have been discussed. Recent advances in modern technologies in the field of biomedical and biological sciences also have been covered in this manuscript.

Background: Better and early prediction of malignant thyroid nodule, and sure differentiation from benign one, is crucial need to decrease the rate of non-indicated surgeries. The aim of the work: To find risk factors and predictors of malignancy in patients with thyroid nodule[s]. Patients and Methods:Fifty patients with thyroid nodule[s] were included. All patients were evaluated by history taking, clinical examination and laboratory investigations. Imaging studies included thyroid ultrasound [US]. All were also submitted to fine needle aspiration cytology [FNAC] before treatment by total or subtotal thyroidectomy. Excised tissues were sent to histopathological analysis. Results:The incidence of malignancy was 22.0%. both benign and malignant groups were comparable as patient characteristics, complaints except the significant increase in cosmetic disfigurement among patients with benign nodules [92.3% vs. 45.5%].Patients with malignant nodules had a significant increase of ill-defined margins, intranodular vascularity and enlarged lymph nodes [72.7%, 63.6% and 72.7% vs 5.1%, 12.8% and 25.6% respectively]. Ill-defined margins, enlarged lymph node and high grade in FNAC were the predictors of thyroid malignancy. Conclusion: Predictors of malignant thyroid nodules are ill- defined edges, enlarged lymph node and high grade in FNAC. This helps clinicians to spare more benign cases from surgical interference.

Forest fires are among the most dangerous accidents, as they lead to the repercussions of climate change by reducing oxygen levels and increasing carbon dioxide levels. These risks led to the attention of many institutions worldwide, most notably the European Union and the European Parliament, which led to the emergence of many directives and regulations aimed at controlling the phenomenon of forest fires in Europe, such as the (E.U.) 2019/570. Among the proposed solutions, the usage of unmanned aerial vehicles (UAVs) is considered to operate alongside existing aircraft and helicopters through extinguishing forest fires. Scientific researches in this regard have shown the high effectiveness use of UAVs. Still, some defects and shortcomings appeared during practical experiments represented in the limited operating time and low payload. As UAVs are used for firefighting forest fires, they must be characterized by the heavy payload for the extinguishing fluids, long time for flight endurance during the mission, the ability to high maneuver, and work as a decision-making system.In this paper, a new UAV platform for forest firefighting is represented named WILD HOPPER.WILD HOPPER is a 600-liter platform designed for forest firefighting. This payload capacity overcomes typical limitations of electrically powered drones that cannot be used for anything more than fire monitoring, as they do not have sufficient lifting power. The enhanced capabilities of the WILD HOPPER allow it to complement existing aerial means and overcome their main limitations, especially the need to cover night operations. This allows reducing the duration of the wildfires heavily by allowing continuous aerial support to the extinguishing activities once the conventional aerial means (hydroplanes and helicopters) are set back to the base at night. On the other hand, WILD HOPPER has significant powerful advantages due to the accuracy of the release, derived from multirotor platform dynamic capabilities.

The presence of heavy metals in drinking water or wastewater poses a serious threat to the ecosystem. Hence, the present study focused on synthesizing SnCaAl2O3 core-shell nanoparticles (C.N.P.s) in the α-Alumina phase by thermal annealing a stacked structure sandwiched between two Al2O3 layers at low temperatures. The obtained structure showed Sn N.P. floating gate with an Al2O3 dielectric stacked tunneling barrier to remove the excess of these heavy metals from polluted water. To characterize the prepared composites, X-ray diffraction (XRD), field emission scanning electron microscope (FE-SEM), and high-resolution transmission electron microscopy (HR-TEM) were used. The synthesized SnCaAl2O3 C.N.P.s composite was examined to utilize it as an adsorbent for removing Zn, Cd, and Pb divalent cations. The removal efficiency was studied by various parameters such as adsorbent dose, pH, contact time, metal concentrations, temperature, and coexisting ions. The experimental results were tested via Langmuir and Freundlich isotherm models. The obtained results were convenient to the Freundlich isotherm model. Moreover, the adsorption thermodynamic behavior of Zn+2, Cd+2, and Pb+2 on the synthesized composite was examined, and the process is endothermic and spontaneous under experimental conditions. The results illustrated that the adsorption efficiency of the SnCaAl2O3 core-shell nanoparticles (C.N.P.s) ranged from 88% to about 100% for all cations.

OBJECTIVES/BACKGROUND:. Extracorporeal membrane oxygenation is used as rescue therapy for patients with acute respiratory distress syndrome in whom conventional therapy has failed prior to an Extra Corporeal Membrane Oxygenator to rescue Lung Injury in Severe Acute Respiratory Distress Syndrome trial. Since then, extracorporeal membrane oxygenation has been incorporated as part of the standard treatment algorithm in many centers for patients with severe acute respiratory distress syndrome. Since the emergence of coronavirus disease 2019 in early 2020, extracorporeal membrane oxygenation has been used effectively as rescue therapy and as a bridge to recovery in some patients with refractory respiratory failure. DESIGN, SUBJECT, AND INTERVENTION:. We present a 38-year-old male healthcare worker diagnosed with coronavirus disease 2019 and progressed to critical condition with severe surgical emphysema on a high-flow nasal cannula with Fio2 100%, a flow of 40 L/min, and a maximum oxygen saturation of 88%. He was successfully treated by applying awake extracorporeal membrane oxygenation, without a need for invasive mechanical ventilation, to avoid worsening barotrauma and hemodynamic compromise potentially induced by positive pressure ventilation. MAIN RESULTS AND CONCLUSIONS:. To our knowledge, this is one of the first cases to be reported in the literature on the use of awake extracorporeal membrane oxygenation as a “treatment” for barotrauma due to severe acute respiratory distress syndrome in a coronavirus disease 2019 patient, without the need for invasive mechanical ventilation. In selected patients with severe respiratory failure, awake extracorporeal membrane oxygenation can be used as a salvage treatment and obviate the need for invasive mechanical ventilation.

Abstract Background Patients undergoing craniotomy operations are prone to various noxious stimuli, many strategies are commenced to provide state of analgesia, for better control of the stress response and to overcome its undesired effects on the haemodynamics and post-operative pain. Scalp nerves block are considered one of these strategies. This study was conceived to evaluate the effect of addition of hyaluronidase to the local anaesthetic mixture used in the scalp nerves block in patients undergoing elective craniotomy operations. Methods 64 patients undergoing elective craniotomy operations were enrolled in this prospective randomized, double-blind comparative study. Patients were randomly assigned to two groups. Group LA, patients subjected to scalp nerves block with 15 ml bupivacaine 0.5%, 15 ml lidocaine 2%, in 1:400000 epinephrine. Group H as Group LA with15 IU /ml Hyaluronidase. Results Patients in the H group showed lower VAS values for 8 h postoperative, compared to the LA group. The haemodynamic response showed lower values in the H group, compared to the LA group. Those effects were shown in the intraoperative period and for 6 h post-operative. No difference was detected regarding the incidence of complications nor the safety profile. Conclusion Our data supports the idea that addition of hyaluronidase to the local anesthetic mixture improves the success rates of the scalp nerves block and its efficacy especially during stressful intraoperative periods and in the early postoperative period. No evident undesirable effects in relation to the addition of hyaluronidase. Trial registration Clinical Trial registry on ClinicalTrials.gov, NCT 03411330, 25-1-2018.

Introduction: About 50% of patients with cancer develop bone metastasis mainly presenting with distressing, drug-resistant pain. Aim of the work: The study evaluated efficacy and safety of combined cementoplasty and bony radiofrequency ablation in palliation of intractable pain and disability in cancer patients with bony metastases. Patients and methods: The study included 30 adult patients suffering from localized bony metastases causing refractory moderate to severe pain. Radiofrequency bony ablation performed followed by cementoplasty were done under computed tomography (CT) guidance with conscious sedation and local anesthesia. Final CT check was done to ensure adequate lesion filling and to exclude any cement leakage. Pain, hemodynamic variables, and neurological status were checked for a minimum of 2 h before discharge. The patients were followed up weekly in the pain clinic. The primary outcome measures pain severity and daily opioid consumption. The secondary outcome measures were quality of life and the degree of disability, and procedure-related adverse outcomes. Results: Pain score, daily morphine consumption, and Oswestry Disability Index score decreased significantly after 1 day, and 1, 4 and 12 weeks. None of the patients had serious complications during the postoperative follow up visits. Only 4 patients (13.3%) experienced discomfort during, and few days after the procedure, 3 patients (10%) suffered from local infection, and 2 patients (6.7%) reported cement leakage. Conclusion: Combined radiofrequency ablation and cementoplasty is a safe and effective pain relief modality in patients suffering from extraspinal painful bone metastases with improvement of the quality of life. Keywords: Radiofrequency ablation, Cementoplasty, Localized bony metastases, Intractable pain

Objectives: To evaluate the outcome of priming by varying-doses of metoclopramide on propofol injection pain in comparison to lidocaine as a standard control. Methods and materials: 320 patients were randomly allocated into 4 equal groups: Group C received 50 mg lidocaine and Groups M1-3 received metoclopramide 2.5, 5 and 10 mg, respectively. An elastic tourniquet was applied to the mid of left arm, the priming solution was injected over 10 s and 1-min later, tourniquet was removed and one fourth of the total calculated dose of Propofol was injected over 30 s and pain assessment was made, during initial and at end of injection of Propofol trial dose, using the 4-point verbal rating scale: no, mild, moderate or severe pain. Then, the reminder of the full calculated induction dose of Propofol was completed. Results: Lidocaine and metoclopramide mostly relieved pain of initiation of Propofol injection 174 patients (54.4%) had no pain 94 patients (29.4%) had mild pain and only 68 patients (21.25%) had moderate pain, while no patient had severe injection pain. At the end of injection of the total trial dose, 40% had no pain totally, 31.3% had mild pain, 19.3% had moderate pain and 9.4% had severe pain. Lidocaine provided significantly better analgesia compared to metoclopramide (2.5 mg), while the difference was non-significantly better compared to metoclopramide, 5 and 10 mg. Metoclopramide provided dose-dependent stepwise pain relieve peaking with 10 mg dose that showed significant superiority compared to 2.5 mg dose, but non-significantly compared to 5 mg dose. Moreover, the effect of 10 mg priming dose extended till completion of injection of the trial dose with significant difference Compared to the other two doses of metoclopramide. Conclusion: venous priming with metoclopramide 10 mg with mid-arm tourniquet applied for one minute is effective modality for alleviation of Propofol injection pain else Patients received Lidocaine showed significantly better analgesia compared to those received 2.5 mg metoclopramide. Keywords: Propofol injection pain, Metoclopramide, Lidocaine, Tourniquet, Venous priming

Objectives: We assessed whether at admission plasma circulating cell free mitochondrial DNA (ccf-mtDNA) is related to injury severity and can predict morbidity and mortality in acute trauma patients. Patients and methods: Patients were evaluated at Emergency Department (ED) using Injury Severity Scale (ISS), but only patients required ICU admission were studied (Group B). At ED arrival, blood samples were obtained for quantitative real-time PCR estimation of plasma level of ccf-mtDNA. Study outcome was the correlation between morbidity and mortality and at admission plasma ccf-mtDNA level and its predictability for morbidity and mortality. Ten healthy volunteers gave blood samples as control group (Group B). Results: Twenty-seven patients passed smooth ICU stay and were discharged alive (Group B1), while 34 patients developed additional morbidities (Group B2) and 11 patients (18%) of Group A2 died. Mean estimated plasma ccf-mtDNA levels were significantly higher in Group B than in Group A, but patients of Group B1 had significantly lower ccf-mtDNA levels than patients of Group B2. Patients developed adult respiratory distress syndrome (ARDS) had significantly higher ccf-mtDNA levels than patients developed sepsis or acute myocardial infarction (AMI) with significantly higher levels in patients developed sepsis. Estimated plasma ccf-mtDNA levels at time of admission showed positive significant correlation with morbidity rate. Odds ratio (OR) for relative risk for development of additional morbidities in patients who had a high plasma ccf-mtDNA level was 26.35. At admission plasma ccf-mtDNA levels in survivors were significantly lower than in non-survivors, and OR was 4.0806. High plasma ccf-mtDNA showed high sensitivity as predictor for ICU mortality. Conclusion: High at ED admission plasma ccf-mtDNA levels could predict development of additional morbidities during ICU stay of acute trauma patients and showed high sensitivity for prediction of their survival. Very high plasma ccf-mtDNA levels could predict patients liable to develop ARDS.

Objective: To compare the impact of individual elements of difficult embryo transfer (D-ET): cervical traction (Cx-Tr), blood on outer sheath (Bl-OS), blood on transfer catheter (Bl-TC) and sounding (Snd) individually and in combination on clinical pregnancy rate (CPR) and implantation rates (IR) of ICSI cycles. Methods: A retrospective cohort study included 744 ICSI cycles. Easy embryo transfer (E-ET) was diagnosed if no resistance on passing the preloaded TC and the sheath through the cervix. Difficult transfer was defined if Cx-Tr and/or Snd was needed, and Bl-OS or Bl-TC was present. Cycle outcome was compared for E-ET and D-ET as a whole and individually with subgroups using Odds Ratio and 95% CI. Results: CPR for E-ET (45.6%) and D-ET (39.8%) is not statistically significantly different. Comparing E-ET with Cx-Tr, Bl-OS or Bl-TC, Snd showed significantly lower CPR with Bl-TC and Snd subgroups only. Although IR showed no significant difference between E-ET and over all components of D-ET it tended to be lower for Bl-TC and Snd subgroups. Conclusion: Cx-Tr and/or Bl-OS do not compromise CPR or IR. Only when Bl-TC and/or Snd the uterus at the time of ET is the CPR significantly undermined and IR tends to be impaired.