Search

Swimmers' personal hygiene affects the spread of microbes in pools. The present study aimed to determine the incidence of microbial infections among young Egyptian swimmers and its impact on swimmers' scores. From January 2020 to June 2021, 528 public club swimmers were examined cross-sectionally. Swimmers were divided into two groups according to their star tests and their scores in the competition (group 1 with a high score and group 2 with a low score). Stool samples, biochemical and biological parameters were assessed. Microbial infections were 54% for intestinal parasitosis and 2.8% for Helicobacter pylori. The rate of intestinal parasitosis was higher among Gp2 as compared to Gp1. The results also revealed higher prevalence of Cryptosporidium spp., Giardia lamblia, Entameba histolytica, and Cyclospora among Gp2 than Gp1. Swimming frequency, and duration influenced the infectious status that induced anemia, abnormal blood pressure, and heart rate. Infected swimmers with cryptosporidiosis had higher alanine transaminase levels, white blood cells, and differential cells but lower aspartate transaminase levels. Giardiasis showed higher reduction in the biochemical markers including ferritin, lactoferrin, iron, and transferrin among Gp 2, compared to Gp 1 and thus affected the swimmers' scores. Thus, raising swimmers' hygiene awareness and targeting health education is obliged., (© 2023. The Author(s).)

Pregabalin (PRG) possesses great therapeutic benefits in the treatment of epilepsy, neuropathic pain, and fibromyalgia. However, clinical data have reported incidence or exacerbation of heart failure following PRG administration. Experimental data exploring cardiac alterations and its underlying mechanisms are quite scarce. The aim of the present work was to investigate the effect of PRG on morphometric, echocardiographic, neurohumoral, and histopathological parameters in rats. It was hypothesized that alterations in cardiac renin angiotensin system (RAS) might be involved in PRG-induced cardiotoxicity. To further emphasize the role of RAS in the mechanism of PRG-induced cardiotoxicity, the protective potential of diminazene aceturate (DIZE), an ACE2 activator, was investigated. Results showed 44% decrease in ejection fraction and sevenfold increase in plasma N-terminal pro-brain natriuretic peptide. Histopathological examination also showed prominent vacuolar changes and edema in cardiomyocytes. In addition, PRG significantly increased angiotensin II (Ang II), angiotensin converting enzyme (ACE) and angiotensin II type 1 receptor (AT1R) levels, while decreased angiotensin 1-7 (Ang 1-7), angiotensin converting enzyme 2 (ACE2), and Mas receptor (MasR) cardiac levels. DIZE co-administration showed prominent protection against PRG-induced echocardiographic, neurohumoral, and histopathological alterations in rats. In addition, downregulation of ACE/Ang II/AT1R and upregulation of ACE2/Ang 1-7/MasR axes were noted in DIZE co-treated rats. These findings showed, for the first time, the detailed cardiac deleterious effects of PRG in rats. The underlying pathophysiological mechanism is probably mediated via altered balance between the RAS axes in favor to the ACE/Ang II/AT1R pathway. Accordingly, ACE2 activators might represent promising therapeutic agents for PRG-induced cardiotoxicity.

Pregabalin (PRG) is highly effective in the treatment of epilepsy, neuropathic pain and anxiety disorders. Despite its potential benefits, PRG administration has been reported to induce or exacerbate heart failure (HF). It has been previously documented that overactivation of the renin angiotensin system (RAS) is involved in HF pathophysiological mechanism. The target of the current study was to examine the possible cardioprotective effect of telmisartan (Tel), an angiotensin II type 1 receptor (AT1R) blocker, compared with that of captopril (Cap), an angiotensin converting enzyme (ACE) inhibitor, in ameliorating PRG-induced HF in rats by assessing morphometric, echocardiographic and histopathological parameters. Furthermore, to investigate the role of RAS blockade by the two drugs in guarding against PRG-induced changes in cardiac angiotensin 1-7 (Ang 1-7) and angiotensin II (Ang II) levels, in addition to myocardial expression of ACE2, ACE, Mas receptor (MasR) and AT1R. Results showed that PRG administration induced morphometric, echocardiographic and histopathological deleterious alterations and significantly elevated cardiac Ang II, ACE and AT1R levels, while reduced Ang 1-7, ACE2 and MasR cardiac levels. Concurrent treatment with either Tel or Cap reversed PRG-induced morphometric, echocardiographic and histopathological abnormalities and revealed prominent protection against PRG-induced HF via downregulation of ACE/Ang II/AT1R and upregulation of ACE2/Ang 1-7/MasR axes. These are the first findings to demonstrate that the potential benefits of Tel and Cap are mediated by counteracting the altered balance between the RAS axes induced by PRG. Hence; Tel and Cap may attenuate PRG-induced HF partially through stimulation of ACE2/Ang 1-7/MasR pathway., (Copyright © 2019 Elsevier B.V. All rights reserved.)

A total of 93 infertile and 70 fertile men attending various urology and gynecology clinics in Jordan were investigated in this prospective study. First void urine and the corresponding semen specimens were collected from 96% of the patients. Presence of Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), and Mycoplasma genitalium (MG) DNA in specimen was detected using polymerase chain reaction. The distribution of NG, CT, UU, and MG in semen and FVU specimens among infertile versus fertile men was 6.5% versus 0%, 4.3% versus 1.4%, 10.8% versus 5.7%, and 3.2% versus 1.4%, respectively. Two of infertile and 1 of fertile men harbored mixed pathogens. The highest number of positive potential pathogens was found among young men aged 20-29 years old. The present study found a very high concordance between the detection of CT, UU, and MG DNA in semen and the corresponding FVU specimens, while NG DNA found only in semen and not in the corresponding FVU specimens. This study also revealed that Ureaplasma parvum species is more prevalent than Ureaplasma urealyticum in specimens of infertile men (90%). The study demonstrates that infertile men have higher prevalence of NG, CT, UU, and MG compared with fertile men and NG as significantly associated with infertile men., (© 2013.)

We evaluated the role of free prostate specific antigen (f-PSA) serum level and its related parameters in detecting prostate cancer. This retrospective study was conducted between January 2006 and March 2008. Transrectal ultrasound guided prostate biopsy was performed for 107 patients who had total PSA (t-PSA) level of either >4 ng/mL with or without palpable nodule or ≤4 ng/mL with palpable nodule on digital rectal examination. The performance measurements for f-PSA, percent free PSA (%f-PSA) and free PSA density (f-PSAD) were determined and compared with those for t-PSA and total PSA density (t-PSAD). Descriptive statistics for all variables of interest were calculated, and receiver operating characteristic curves were generated. Nine patients (8.4%) had normal histology, 69 patients (64.4%) had benign disease and 29 patients (27.1%) had prostate cancer. The performance of f-PSA in PCa detection was better than other evaluated parameters. The largest area under the curve for patients in the gray area (t-PSA range 4.1-10 ng/mL) was for f-PSA, with a value of 0.64 and a sensitivity and specificity of 44% and 87%, respectively. For %f-PSA, these values were 0.59, 63% and 62%, respectively. For patients with a t-PSA level of 10.1-20 ng/mL, they were 0.68, 67%, and 81%, respectively, for f-PSA, and 0.64, 67%, and 76%, respectively, for %f-PSA. In conclusion, f-PSA serum levels performed better than free to total PSA ratio and t-PSA for prostate cancer screening. It is of clinical value which could affect the biopsy decision avoiding unnecessary interventions.

Objectives: To determine the effect of adding dexmedetomidine to bupivacaine for neuraxial anesthesia., Methods: Sixty-six patients were studied between April and May 2008 in the University of Jordan, Amman Jordan. They were randomly assigned into 3 groups, each receiving spinal bupivacaine 12.5mg combined with normal saline (group N) Dexmedetomidine 5 microg (group D5), or dexmedetomidine 10 microg (group D10). The onset times to reach T10 sensory and Bromage 3 motor block, and the regression times to reach S1 sensory level and Bromage 0 motor scale, were recorded., Results: The mean time of sensory block to reach the T10 dermatome was 4.7 +/- 2.0 minutes in D10 group, 6.3 +/- 2.7 minutes in D5, and 9.5 +/- 3.0 minutes in group N. The mean time to reach Bromage 3 scale was 10.4 +/- 3.4 minutes in group D10, 13.0+/-3.4 minutes in D5, and 18.0 +/- 3.3 minutes in group N. The regression time to reach S1 dermatome was 338.9 +/- 44.8 minutes in group D10, 277.1 +/- 23.2 minutes in D5, and 165.5 +/- 32.9 minutes in group N. The regression to Bromage 0 was 302.9 +/- 36.7 minutes in D10, 246.4 +/- 25.7 minutes in D5, and 140.1 +/- 32.3 minutes in group N. Onset and regression of sensory and motor block were highly significant (N vesus D5, N versus D10, and D5 versus D10, p<0.001)., Conclusion: Dexmedetomidine has a dose dependant effect on the onset and regression of sensory and motor block when used as an adjuvant to bupivacaine in spinal anesthesia.

High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arterial-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed.

Objective: Continuous bupivacaine paravertebral nerve block after thoracotomy has been shown to reduce postoperative pain. This study was designed to determine whether paravertebral nerve block using bupivacaine infused through a catheter placed intraoperatively, can reduce postoperative pain, and analgesia requirements after loin incision., Methods: Thirty-four patients undergoing renal surgery through loin incision at Jordan University Hospital, Amman, Jordan, from October 2001 to March 2003, were randomized either to receive bupivacaine 0.5% or normal saline through a catheter positioned intraoperatively against the costovertebral joints in the paravertebral space. The infusions were continued until the evening of the third postoperative day. Patients had access on request to intramuscular Morphine sulphate 5-15 mg, or Diclofenac sodium 50-100 mg, or both depending on body weight. Pain after operation was assessed at rest using linear visual analogue scale. Patient scores were recorded in the recovery room, at 4 hours, 8 hours, and at 9 am, and 5 pm., Results: The analgesia requirements for each patient were recorded. Pain scores in the recovery room were significantly lower in the bupivacaine group (mean 4.5 versus 8.0, p=0.001). At 4 hours, the pain score was lower in the bupivacaine group though not significant (mean 3.5 versus 4.37, p=0.393). Thereafter, the pain scores were significantly lower in the bupivacaine group. Mean morphine requirement in the bupivacaine group was 13.3 mg (ranges 0-50), while in the saline group 40.13 mg (range 10-112.5), p<0.001. Morphine requirements in the first and second postoperative days were significantly less in the bupivacaine group (p=0.015 and p=0.03)., Conclusion: Paravertebral blockade using bupivacaine is an effective and safe method for pain relief following renal surgery through loin incision.

Objective: To detect Chlamydia trachomatis infection among 230 patients, 130 with signs or symptoms associated with urethritis, and 100 asymptomatic patients, attending the Jordan University Hospital urology clinic., Methods: Routine urine examination and the leukocyte esterase test were done for each patient. C. trachomatis infection was detected using first-void urine specimens and a cryptic plasmid-based PCR technique specific for C. trachomatis., Results: The prevalence of chlamydial infection was 4.6% among symptomatic patients with urethritis. The difference in prevalence was statistically insignificant (P > 0.05) between males and females, as well as in relation to their marital status. Two-thirds of the Chlamydia-positive patients also had urine positive for leukocyte esterase., Conclusion: The low prevalence of chlamydial infection in association with urethritis among Jordanian patients might be due to the conservative behavior of the Jordanian society towards free sexuality.

We report the case of a 74-year-old man with a colovesical fistula caused by a gallstone that was lost during a laparoscopic cholecystectomy 7 months earlier. The patient was cured after undergoing colonoscopic removal of the stone. To our knowledge this is the first case report of such a complication in the English literature. The report reviews the outcome and complications of retained intraperitoneal gallstones.