Recent Developments in Medicine and Medical Research Vol. 13

Human leukemia cell lines are powerful tools for investigating basic and applied aspects of T cell biology.  The leukemia cells mimic the normal activity of T cells, among other advantages, they offer worldwide availability of identical cell material, and they can  be  cryopreserved.  The phosphatase PP4 is a PP2A-related, okadaic acid-sensitive, serine/threonine protein phosphatase that shares 65% amino acid identity with PP2A.  Many studies have shown that protein phosphatase is involved in the regulation of T-cell signalling and activation. We have investigated the effect of over expression of PP4 in the expression of the member of the MAP kinase family in Jurkat leukemia T cells which have been previously stimulated with UV, TPA, Ionomycin and okadaic acid.   We found that over expression of PP4 expressed relatively low activity in the absence of any kind of stimulation.  However, TPA, UV or Ionomycin treatment strongly increases the activity of PP4. In addition, Jurkat T cells, transfected with various expression plasmids and/or stimulated with TPA, UV or Ionomycin strongly induces the c-Jun N-terminal kinase (JNK) and p38, whereas ERK-1/2 kinase pathway are weekly activated. Treatment of Jurkat T cells with okadaic acid, an inhibitor of PP2 phosphatase; also inhibit the increasing of JNK and p38 activity induced by PP4. The effect of okadaic acid in the activity of PP4 was similar to the observed in Jurkat T cells treated with a dominant negative for c-Jun (dn-jun).  These results indicate that activation of JNK and p38 but not of ERKs is a target for the PP4 phosphatase activity in Jurkat leukemic T cells. 

The Tax protein of the HTLV-l retrovirus, which causes an aggressive form of T cell leukemia called adult T cell Leukemia (ATL), works via similar mechanisms as CD28 costimulation (the target sites are the same) to upregulate the expression of many cytokines known to be produced by infected cells. Some of these cytokines, particularly IL-2, are important for T cell proliferation and growth. Although it is not yet known how this contributes to the formation of leukemia, it is certain that Tax transactivation of cellular gene expression is important to its ability to transform cells. On the other hands, the all-trans-retinoic acid (ATRA) decreases JNK-1 activity, antagonizing the effect of the Tax protein in Jurkat Leukemia T cell transiently transfected for expressing the Tax protein. 

The decrease in JNK-1 activity was following for a marked decrease in the expression of IL-2 and IFN-g in Jurkat cells treated with ATRA in a doses-dependent manner suggesting a correlation between the expression of the JNK-1- and the activity of Tax protein.  The ATRA treatment was unable to decrease the expression of IL-4 and IL-10.  A luciferase assay using a well-known reporter gene expressing the IL-2 promoter or a tandem repeat of AP-1 or NF-B, demonstrated that both, AP-1 and NF-kB were affected by ATRA treatment.  In addition, our date showed that JNK-1 is constitutively activated in Jurkat Leukemia T cells expressing the Tax protein suggesting that JNK-1 is required for Tax induced proliferation of Jurkat leukemia cells. 

Introduction: Redox status (RS) perturbations and inflammation are fundamental features of chronic kidney disease (CKD) that are substantially exacerbated in end-stage renal disease (ESRD).

Aim: This study aimed at investigating the efficacy of a 6-month intradialytic exercise training program on RS, inflammation and physical performance in patients with ESRD.

Materials and Methods: Twenty hemodialysis (HD) patients (17 males, 3 females) were randomly assigned to either an intradialytic training (bedside cycling) group (TR; n = 10) or a control group (CON; n = 10) for 6 months. Anthropometrics [body mass and height, body mass index (BMI), body composition], physical performance (VO_2peak), functional capacity [North Staffordshire Royal Infirmary (NSRI) walk test, sit-to-stand test (STS-60)], quality of life [(short form-36 (SF-36)] as well as RS [thiobarbituric acid reactive substances (TBARS), protein carbonyls (PC), reduced (GSH) and oxidized (GSSG) glutathione, GSH/GSSG ratio, total antioxidant capacity (TAC), catalase activity (CAT)] and high-sensitivity C-reactive protein (hs-CRP) were assessed at baseline and after the 6-month intervention.

Results: Peak oxygen consumption (VO_2peak) increased by 15% only in TR (p < 0.01). Performance in NSRI, STS-60 and SF-36 improved by 4–13% only in TR (p < 0.01). Exercise training reduced TBARS (by 28%), PC (by 31%) and hs-CRP (by 15%), and elevated GSH (by 52%), GSH/GSSG ratio (by 51%), TAC (by 59%) and CAT (by 15%) (p < 0.01).

Conclusion: These findings suggest that engagement in chronic intradialytic cardiovascular exercise alters RS, reduces inflammation and improves performance in patients with ESRD. Future studies are required to examine this scenario using a larger sample size, to allow for the extraction of safe conclusions.

The aim of our study was to investigate the association of osteosarcoma with syndromic features and the potential effects in the prognosis of osteosarcoma. Osteosarcoma is a tumor derived from mesenchymal cells. Osteosarcoma mainly affects children of 10-14 years old, usually of primary aetiology. Some genetic disorders have been shown to increase osteosarcoma incidence. A case series report of six cases with different syndromes was reported in this study and we have retrospectively evaluated the prognosis of the cases. Data was collected from January 2003 till December 2011 at King Hussein Cancer Center in Jordan. A total of 69 patients were diagnosed to have osteosarcoma during the studied period, 6 of them having associated syndromes, constituting 8.7% of all cases. The syndromes identified were Rothmund-Thomson Syndrome, Osteogenesis Imperfecta, Diamond-Blackfan Anemia, Osteopoikilosis, and Cockayne Syndrome. From the 63 non-syndromic patients follow up was lost in 14 of them. Among the remaining 49 patients, 34 (69.3%) were alive and 15 (30.6%) died, while among the syndromic patients one was lost for follow up, only one remained alive (20%), and 4 died (80%). The statistical analysis indicated that syndromic patients presented a poorer prognosis than non-syndromic patients since an association with a higher mortality rate was observed (p<0.05). Our results suggest that syndromic patient’s show a poorer prognosis and osteosarcoma should be suspected during differential diagnosis and follow up of their syndromes. Early diagnosis and treatment might improve the outcome and survival.

Human coronaviruses (HCoVs) cause respiratory diseases infecting the upper and/or lower respiratory tract.  The six human coronaviruses so far identified are HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU-1, SARS-CoV, and MERS-CoV. Four of these coronaviruses (HCoV-229E, HCoV-OC43, HCoV- NL63, and HCoV-HKU-1) are known as circulating common coronavirus found continuously in the human population causing mostly common cold, with few cases of severe diseases. In late December 2019, a novel human coronavirus, now called SARS-CoV-2, was identified during an outbreak in Wuhan, China. The disease spectrum caused by this virus is now called COVID-19 (Coronavirus Infectious disease 2019). This novel coronavirus has spread globally resulting in a world-wide pandemic that continues to rage as of now. SARS-CoV-2 has a high case morbidity and mortality rate and is high risk to the elderly populations, immune-compromised populations, and to those who have other critical issues like heart disease, diabetes, etc.

Our objective is to find a better therapeutics that can overcome the demerits of the present antiviral strategies adopted for COVID-19. In brief, our goal is to develop a highly effective broad-spectrum nano-polymer based drug candidate against Coronaviruses, and its mutants are also unlikely to enable  to escape these drug candidates.

In this review, we summarize the latest information of the epidemiology, pathogenesis, and clinical aspects of SARS-CoV-2, and discuss the current scientific and therapeutic advancements for clinical treatment of this pandemic novel coronavirus.

A novel coronavirus was an outbreak in Wuhan, China in late December 2019 cause the global pandemic. This SARS- CoV-1 (Wuhan-Hu1) is transmitted from bats to human in Wuhan, China. Then spread over Wuhan to Europe, Asia, African continents to cause massive outbreak. The circulating virus in India is a SARS-CoV-2, a genetically diverse form of SARS-CoV-1. The virus is highly contagious and spreads human-to-human rapidly with confirmed cases in almost every country across the world and has become a new global public health crisis. The virus infects the human respiratory epithelial cells by binding through Angiotensin-Converting Enzyme 2 (ACE2) receptors. Currently, there is no definite treatment for COVID-19 although some drugs are under investigation. This book chapter focusses on the review of the current SARS-CoV-2 outbreak emphasizing epidemiology, pathogenesis, prevention strategies and discussed the current scientific advancements to combat the epidemic novel coronavirus. The knowledge concerning this virus is evolving rapidly and hence the readers are encouraged to update themselves regularly. The measure epidemic control in India is prepared through laboratory set up for diagnosis, social distancing, travel ban, digital contact tracing and finally completely lockdown. The Ministry of Health and Family Welfare, Government of India is actively engaged in epidemic measures in different states of India.

Background: Contraception is critical in preventing unintended pregnancies, lowering maternal and child mortality and improving the lives of women and their families.

Aim and Objective: To determine the pattern of contraceptive usage, uptake rates of the contraceptives, the trend of acceptance, the socio-demographic characteristics and sources of information on contraceptive use at the Rivers State University Teaching Hospital during the study period.     

Methods: This was a retrospective study of clients’ records in family planning clinic at the Rivers State University Teaching (RSUTH) over a period of ten years. Their records were retrieved, reviewed; data extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY).

Results:  There were 1893 contraceptive acceptors attending family planning clinic between 1^st January, 2008 and 31^st December, 2017 in the centre. Throughout the study period, there was a downward trend in contraceptive uptake. Over half of the clients (60.7%) were between the ages of 30 and 39, with 6 (0.3%) being under the age of 20. Age range for the study was 19-51years. Majority of the users (66.1%) were multipara while 22 (1.2%) were nullipara. Modal parity was para 3. The women with formal education were 1862 (98.4%). Most of the clients were married 1814 (95.8%) and of Christian religion 1813 (95.7%). Most preferred contraceptive method was the intrauterine contraceptive device (IUCD), 814 (43%). Clinical personnel were the commonest source of information accounting for 1425 (75.3%).

Conclusion: During the study period, there was a downward trend in contraceptive use. The majority of clients were in their thirties, married, well-educated, and multiparous. Most preferred method of contraception was IUCD.

Gas gangrene is the term used to describe necrotizing skin and soft tissue infection by gas forming organisms. In the modern era, this type of infection is rarely seen outside theatres of war. Patients often present in sepsis, shock or organ dysfunction. Without prompt therapy, gas gangrene has high mortality therefore early diagnosis and swift initiation of antibiotic therapy forms the cornerstone of management. Radical surgical therapy is usually required.

Background: Accidents and suicides claim a large number of human lives every year. Each unnatural death either due to accident or suicide is a personal tragedy that permanently takes the life of an individual and has a continuing ripple effect, dramatically affecting the lives of families, friends and communities. Every year more than 100000 people commit suicide in India. National crime records bureau- Ministry of home affairs-Govt. of India (NCRB) collects data on suicide from police recorded cases. A total of 1, 39,123 suicides were reported in the country during 2019 [1]. This figure is 3.4% more than no. of suicides in 2018.There are many methods of committing suicide. The means adopted for committing suicide varies from the easily available and effective means such as consumption of poison, jumping etc. to more painful means such as self-inflicted injuries, hanging etc. Hanging (53.6%), consumption of poison (25.8%), Drowning (5.2%) and fire/self-immolation (3.8%) were prominent means/mode of committing suicide. The incidence of hanging for committing suicide is increasing. This is a retrospective study carried out at KDN Gohil Hospital, Navsari (Gujarat) to know the outcome of this type of suicidal attempts and to review then management of this type of patients. This small study tries to compare mortality rate and management protocol with other larger studies.

Objectives: Objective of the study is to give details in to the pathophysiology of partial hanging and to discuss about management of such cases. The incidence of hanging is increasing and literature about its management is sparse, so this article makes an attempt to review the literature on this subject and the authors present their own study.

Methods: This study included all patients with a history of hanging or accidental strangulation who were brought to the hospital after being released from the strangulating agent. Various aspects of the agents used for hanging, as well as the patients' characteristic findings and management protocol, were studied retrospectively.

Results: The results were analyzed in terms of survival rate and occurrence of complications. Out of 44 patients, 37 survived and 7 died. There were no injuries to the cervical spine. One patient suffered a laryngeal injury that resulted in laryngeal stenosis.

Conclusion: Suicidal hanging is not the same as judicial hanging. If the patient is brought to the hospital alive, the suicidal hanging survival rate is usually high. The main management steps are early endotracheal intubation, hypotension management, ventilator support, and anti-edema medications.

Aims & Objectives: Onychomycosis is a chronic fungal infection of nails. For identification of the specific pathogen and effective selection of antifungal treatment, the clinical diagnosis of onychomycosis must be validated by direct microscopy and culture. The goal of the study was to determine the prevalence of onychomycosis and its cultural positive in relation to several etiological factors.

Introduction: Dermatophytes are the most common pathogens of onychomycosis, yeasts and non-dermatophyte moulds can also be found as causative agents of onychomycosis.

Materials & Methods: Nail clippings from 90 clinically suspected instances of onchomycosis were collected from O.P.D at S.M.S and E.S.I.C. hospital in Jaipur. Trauma, infection, occupation, diabetes, and personal habits (smoking, etc.) were all thoroughly investigated. Direct microscopy using a 20% KOH examination method and fungal culture on SDA and Dermatophyte Test Media were used to make the diagnosis.

Results: Out of 90 onychomycosis patients, 80 (88.9%) tested positive for KOH, whereas 33 (36.7%) tested positive in culture. Dermatophytes, non-dermatophytes, and yeasts were identified as etiological agents of onychomycosis in this investigation. Patients with distal subungual onchomycosis were shown to have a common type of onychomycosis. Trichophyton rubrum was found to be the most common species among the culture positive cases, followed by Trichophyton mentagrophyte and Trichophyton tonsurans. Non dermatophyte molds were also isolated from white superficial onychomycosis and Candida species was isolated from Candida onychomycosis. In our study, the majority of patients were in the age groups of 41-50 and 51-60 years, and males were the most usually affected. According to the study, the majority of patients infected with onychomycosis infection were service class and sportsmen, followed by labours, housewives, unemployed, students, and farmers.

Conclusion: Based on the findings of this study, it is possible to conclude that onychomycosis is a significant public health issue, and that accurate diagnosis of onychomycosis by direct microscopy and fungal culture is required for appropriate management of such cases.

Introduction: Many herbs and natural food materials have been historically recognized as an effective panacea that can establish a balanced inflammatory response and promoting healthy immune response as well as have antibacterial and viral effects. The clinical use of some medications can cause serious side effects. We proposed that natural ingredients could serve as a better therapeutic approach.

Study Objective: The study aimed to evaluate the effect of IMMUTONIC capsule in human volunteers with flu symptoms.

Methods: Twenty-four male and female adult volunteers, aged between 21 and 60 years were selected for the study.

Study Design: The study has a randomized clinical trials for one week. Volunteers were taken IMMUTONIC capsule three times daily after meal for one week.

Improving of Flu symptoms were follow up after 3 days and 7 days using improving health scale 0-5.

Results: flu symptoms and appetite were significantly improving after 3 days of follow up at p <0.05, while after 7 days were highly significant improving health at p < 0.05.

Conclusion: The present study indicated that Immutonic capsule improves Flu symptoms via improved immune system and its antibacterial & viral effects as well as increased appetite which lead to good feeding.

Novel corona virus 2019 also known as severe acute respiratory syndrome coronavirus 2 [SARS COV2] is enveloped non segmented ribonucleic acid (RNA) virus. Acute ischemic stroke remains emergency during covid19 pandemic [1]. Thrombectomy also plays a crucial role in treating acute stroke patients.  Here we present a case of a woman with COVID 19 who presented to us with symptoms of altered state of consciousness (ASOC), cough, fever, dysarthria, right sided body weakness and massive bilateral middle cerebral artery (MCA)/ anterior. Our case was unique in the sense that it showed drastic central nervous system (CNS) damage in the presence of coronavirus infection. There are a few cases of patients who develop stroke after COVID 19 infection.

Aims: Clinicians need to be aware of possible causes of unconsciousness in coronavirus disease (COVID 19) patients, particularly as delirium appears to be common complications to find out the association between stroke and COVID 19 and its impact and mortality.

Case Presentation: A 70 years old lady presented to us with symptoms of stroke like ASOC, right sided body weakness, dysarthria and symptoms of pneumonia like mild cough and fever later which turned out to be COVID 19. Clinicians need to be aware of possible causes of unconsciousness in coronavirus disease (COVID 19) patients, particularly as delirium appears to be common complications to find out the association between stroke and COVID 19 and its impact and mortality.

Discussion: Bilateral ischemic stroke is relatively uncommon presentation in general population and is usually the result of cardio embolic cause such as atrial fibrillation and recent myocardial infarction. While this patient had pre existing risk factors for stroke such as type 2 diabetes mellitus, hypertension and old age and her electrocardiography showed sinus rhythm.

Conclusion: COVID-19 may be a risk factor or aggravating factor for stroke.

Introduction: a) Colorectal cancer is the fourth (4th) common cancer in both sexes, worldwide and is the third most common cancer in men and the second in women.

1. b) In 2012, 1.36 million cases of colorectal cancer occurred and there were 693,881 deaths
2. c) Incidence is increasing under age 50 and is the second killer cancer in UAE in 2017 [1].
3. d) According to health authority of Abu Dhabi( HAAD) in a report published in 2012 colon cancer is the 2nd common cancer and 4th common cause of cancer deaths in men and 3rd most common cancer and 2nd common cause of cancer deaths in women.(www.haad.ae)
4. e) UAE the data showed average age for colorectal cancer to be 51 years, 59% were men and 41 % were women [2].
5. f) In the Emirate of Abu Dhabi the Health Authority of Abu Dhabi (HAAD) instituted 2013 a colon cancer prevention program including primary preventive strategies by education, weight control & exercise and secondary prevention strategies by either colonoscopy or yearly fecal immune testing starting at age 40-75.
6. g) The campaign was designed to coincide with the global awareness months in march that are assigned for colorectal cancer [3].

Our Study-2012-2021 (Single Center Experience ACDS)included 11770 Colonoscopies performed for multiple indications: a) 2717 Colon Polyps were detected 23%.

1. b) 67 cancers were detected during this period 0.66% [4-6].
2. c) Age range 29-81 years, 24% below 50 years, 13% below age 40.

d)163 precancerous polyps and cancers  23%

Conclusion: a) Our single center (ACDS) data of 11,770 colonoscopies done for a variety of indications showed  colon polyps2717  23%&  67 colorectal cancers 0.66%  .

1. b) 67 cancers, male 62% and female 37 % detected . 24% below age 50, 13% below age 40
2. c) Colorectal cancer affect younger populations.
3. d) The implication for the screening program is to review the screening age and possibly starting at younger ages.
4. e) More data from different centers needed to evaluate the age of colorectal cancer screening.

We present a case of forgotten stent post ureteric stone management in CRFE which was removed by retrograde intrarenal surgery (RIRS). Ureteral double J (DJ) STENT has now become one of the most commonly used tools in endourology. Complications are bound to occur if forgotten to remove, such as encrustations, infection, migration, renal dysfunction, hydronephrosis. Crossed renal fused ectopia is a very rare congenital malformation due to abnormal kidney ascent with fusion during embryogenesis in the first trimester. We report a very rare case of forgotten DJ stent in crossed fused ectopia, in 66 years old diabetic patient post left ureterorenoscopy (URS) done 3 years back. Retrograde intrarenal surgery (RIRS) was done for DJ stent removal Right. Endourological management can achieve a safe and successful outcome in the treatment of forgotten stent. Proper education and counselling of patients and relatives before and after stenting with maintaining stent registry may help reduce incidence of forgotten stents.

This article presents a research of the possibility to apply music education activities for rehabilitation of patients with neurodegenerative disease. The purpose of this work was development of a music psychotherapy program for rehabilitation of patients with Parkinson's neurodegenerative disease. We suggested "target objects" for music rehabilitation therapy at all levels of manifestation of symptoms ofillness: 1) physical restriction and rigidness which includes well-aimed work with breathing and movement symptoms, loss of control, lack of coordination, inflexibility, tremor; 2) emotional deprivation (realization and expression of emotions and feelings) through plastics of movements to music and singing-seeking catharsis through vivified contact with oneself and intensification of feelings ; 3) social deprivation: Well-aimed work on resocialization of the patient. Results we obtained contribute to further understanding and wider application of music education methods, technologies and approaches that may add to rehabilitation practices.

Sleep is a normal physiological phenomenon. Humans spend approximately one-third of their life sleeping. A night of restorative sleep is normally characterized by a sleep duration between 7-9 hours per day, falling asleep easily and staying asleep without interruption, waking up feeling refreshed, and staying awake during the day. However, deviations may result in sleep disorders, which include insomnia, hypersomnolence, parasomnias, sleep-related movement disorders, and circadian rhythm sleep-wake disorders. Breathing disorders may also result in fragmented sleep. Sleep disorders are common all over the world. They are often associated with other health disorders, such as metabolic syndrome, diabetes, and psychiatric illnesses. They also suffer from many behavioral disorders. They are more frequently absent from work, have more accidents, and are less productive. Overall, there is reduced well-being and a decrease in the quality of life in these patients. Sleep disorders also increase mortality. Chronic sleep deprivation is a major financial burden on society. Improper sleep is also consistently and strongly associated with a higher risk of cardiovascular disease. Major cardiovascular diseases include coronary heart disease, high blood pressure, stroke, heart failure, cardiac arrhythmias (including atrial fibrillation and sudden cardiac death), peripheral artery disease, deep vein thrombosis, and vasculogenic erectile dysfunction. Improper sleep plays a negative role in the pathogenesis of all of these.  Sleep-CVD relationship is often bi-directional. Cardiac disorders, especially during intensive care hospitalization, may prevent restorative sleep. Maintenance of a good sleep regimen and treatment of sleep-related disorders is an important goal in the quest for further improving global cardiovascular health. This manuscript reviews normal sleep and the effects of sleep disorders on cardiovascular diseases.

Background: COVID-19 pandemic has caused both physical and mental health crises and the highest morbidity and mortality globally. COVID19 pandemic is even worse than the Flue Pandemic of early 1900s. Simultaneously, COVID-19 have been causing great burden on the mental health of the people globally. Individuals outside their country who underwent quarantine, faced difficulties in accessing mental health services, lack of social and family support and resources are more vulnerable to develop mental health disorders during the SARS-CoV-2 outbreak.

Objective: The aim of this study was to investigate the risk factors and impact of COVID-19 on the mental health of Saudi citizens who study and stay abroad during the COVID-19 pandemic.

Methods: A cross-sectional online survey was conducted concerning Saudi citizens who were outside the country from August 2020 to September 2020. Six hundred sixty two Saudi citizens who were in host countries completed an online sociodemographic data, self-designed questionnaire, and Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scales.

Results: More than 60% of the participants had psychiatric symptoms during the pandemic and 34% and 30% had met the diagnostic criteria for depressive symptoms and anxiety symptoms, respectively. Females, younger age, single or divorced, and those who were staying alone were more likely to experience psychological symptoms. About 7% were dissatisfied with their abilities or skills to adapt to the changes due to COVID-19 pandemic. More than 75% of the participants strongly expressed that living with other colleagues during the pandemic helped them cope better with the adverse circumstances associated the pandemic outbreak.

Conclusion: The COVID-19 pandemic had negative psychological impact on Saudi citizens in foreign countries and significant psychological impact was determined by female gender, young age, single or divorced status, and staying alone. These and other findings highlight the need for removing barriers against easily accessible online mental health services, social and family supports, and timely provision of resources.

Purpose: To study if females with balanced translocation (BT) have a normal ovarian response compared to normal karyotype XX women. And in male with BT, to determine if spermiogram is affected compared to normal XY karyotype men.

Methods: A retrospective analysis in a public IVF centre of 3249 karyotyped patients between 2008 and 2016, 2276 women, and 973 men. Cycle parameters, oocytes and embryo outcomes were examined. Spermiogram of 19 males with BT were compared with 93 normal XY patients. And 12 women with BT were compared with 93 control normal karyotype XX group (CN). An equivalent control group (EQc) of 12 patients was also selected to be accurate with the BT statistical contrast with normal karyotype in both members of the couple. Results of all cycles were compared.

Results: 19 males (1.9%) and 12 women (0.5%) had BT. Men with BT were older than CN group (37.86 ±5.62 vs. 40.26 ± 4.18; t57,590 = -3,169, p = 0.02). Motility (A+B) in fresh was not different (44.8 ± 17.96 vs. 42,28 ± 16.60 in control vs. pathologic; p=0.423) but had a significant lower concentration of spermatozoa (37.69 ± 37.36 vs. 23.49 ± 22.75 mill/ml; t65,04 = 3,191, p = 0.002). After capacitation, progressive motility (A + B) MSR (motile spermatozoa recovery) (70.86 ± 20.57 vs. 80.25 ± 18.94 control vs. pathologic; t292 = -2,589, p = 0.010). Women BT were older than CN (36.55±4.06 vs. 33.96±3.70; p<0.001), FSH was not different (6.54±1.30 vs. 6.39±1.72; p=0.618). BMI (body mass index) was higher in BT (26.73+5.36 vs. 24.32+3.98; p=0.011). Mature MII oocytes obtained was slightly higher in BT with no statistical difference (11.28±4.51 vs. 9.68±6.13; p=0.135), similar maturation rate (90.38% vs. 89.20%; p=0.602) and higher number of divided embryos with no statistical difference (9.03±3.53 vs. 7.28±5.25; p=0.09). Comparison with EQc to avoid differences with age, BMI and FSH values, showed no statistical differences in any of the studied parameters.

Conclusions: Men with a BT have poorer factors affecting sperm quality than control normal XY males. It is recommended to provide a karyotype in males with pathologic spermiogram prior to reproductive treatment. Women carriers of a BT do not have a diminished response pattern to COS (controlled ovarian stimulation) than CN of infertile women with normal karyotype XX. In both cases, an ICSI cycle with PGT and adequate genetic counseling are highly recommended.

Introduction: The neonatal period constitute the initial 4 weeks of extra-uterine life. A variety of clinical manifestations occur in neonates, ranging from physiological to grossly pathological, making it necessary to differentiate between benign and clinically significant skin lesions among newborns. It is critical to recognize transient skin lesions in newborns and differentiate them from other serious conditions in order to avoid unnecessary therapy for the neonates while also assuring parents of a good prognosis for these skin manifestations.

Aims and Objectives: To study the various patterns of cutaneous manifestations occurring among the newborn and to estimate the prevalence of physiological and pathological skin lesions among the new born.

Materials and Methods: An Institutional based, prospective study was conducted in the department of Dermatology, Venereology and Leprosy, Eluru, West Godavari district, A.P. 100 neonates from postnatal ward, pediatric and dermatology departments of the same institution and having at-least one cutaneous manifestation were included in this study. The study was conducted between the period of November 2011 to May 2013.

Results: There were 54 males and 46 females among the 100 infants. There were 89 full-term births, nine preterm births, and two post-term births among them. Physiological skin lesions were the most prevalent among all cutaneous lesions in newborns, accounting for 57.0 percent, followed by eczematous eruptions (18.2%), temporary non-infectious diseases (10.2%), birthmarks (9.1%), and others (5.5%) in decreasing order of incidence.

Conclusion: This study of newborn skin reveals natural variations that occur during the neonatal period. It is critical to understand that the majority of skin lesions in newborns are transient and do not require treatment.

The rehabilitation of compromised patients has always been a challenge for the medical world. The management of a completely edentulous patient with unilateral facial paralysis is a difficult task. This necessitates a change in conventional procedures. Facial paralysis can come on suddenly or can happen gradually over a period of months. This article describes a case of a completely edentulous patient who suffered from facial paralysis on the left side for three years. A liquid-supported denture for the maxillary arch and a neutral zone technique for the mandibular arch were planned to improve function and esthetics.