Evaluation of antimicrobial, Cytotoxic and genotoxic activities of Ganoderma lucidum (Reishi mushroom).

Ganoderma lucidum (GL) is a mushroom used as a traditional remedy for the treatment of various infections since ancient times. This study, was aimed to investigate antimicrobial activity potential of GL against Staphylococcus aureus, Enterococcus faecalis, Listeria monocytogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, Candida glabrata, Candida krusei, and Candida parapsilopsis. Furthermore, it was also aimed to evaluate the toxicity potential of GL. Antimicrobial activities were screened by using microbroth dilution method. With regard to toxicity studies, cytotoxicity was evaluated by using XTT method against NIH3T3 cell lines, whereas genotoxicity study was conducted by Ames MPF 98/100 mutagenicity assay. Obtained data indicated that minimal inhibitory concentration values of the extract against the tested microorganisms ranged from 200 to 400µg/ml. No cytotoxic activity was observed related to the Ganoderma lucidum administrations. However, results of the Ames test pointed out a genetic damage with metabolic activation against TA98. At the highest concentration (5mg/ml) the extract showed 2.71 fold increase over the baseline significantly. (p<0.05). In conclusion, in spite of significant antimicrobial effect potential, Ganoderma lucidum should be used carefully because of its genotoxicity potential.

Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy.

STUDY OBJECTIVE: This study was conducted to determine the changes in ovarian reserve markers after laparoscopic ovarian cystectomy (LOC). DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: University teaching hospital. PATIENTS: Fifty 50 patients who underwent LOC were prospectively examined to determine the changes in serum markers of ovarian reserve, starting from 1 month before and 3 months after consecutive operations. INTERVENTIONS: Changes in serum markers were compared between the following groups: endometrioma cysts (n = 26) versus nonendometrioma cysts (n = 24), unilateral cystectomy (n = 38) versus bilateral cystectomy (n = 12), and bilateral endometrioma extirpation (n = 10) versus other cystectomy operations (n = 40). MEASUREMENTS AND MAIN RESULTS: A significant change was noticed between the preoperative and postoperative antimüllerian hormone (AMH) levels (2.67 ± 2.67 ng/mL vs 1.84 ± 1.72 ng/mL, p < .0001). Serum AMH levels were found to be significantly decreased in endometrioma (p = .002), nonendometrioma (p = .019), unilateral cystectomy (p = .001), bilateral cystectomy (p = .005), bilateral endometrioma (p = .011), and cysts other than bilateral endometrioma (p = .000) groups. CONCLUSION: The ovarian reserve was found to be diminished after LOC regardless of the presence of endometrioma that could be distinguishable by serum AMH levels.

Validity and efficacy of office hysteroscopy before in vitro fertilization treatment.

INTRODUCTION: Office hysteroscopy (OH) allows assessment of the uterine cavity. The aim of this study is to investigate uterine cavity of infertile patients with OH, to treat pathologies and to measure the impact of OH on live birth rates and IVF treatment costs. MATERIALS AND METHODS: 498 IVF patients were selected for this study. Control group (398 patients) underwent IVF without OH evaluation. OH group (100 patients) was assessed prior to IVF and detected intrauterine pathologies were treated. OH group was divided into two subgroups: patients with normal uterine cavity (59 patients) and patients who had intrauterine pathologies (41 patients). Number needed to treat (NNT) was also measured. RESULTS: When live birth rates of the control and OH groups were compared, OH group's rate was significantly higher (18.3 vs. 26 %; p > 0.05). 41 % of the patients in the OH group had intrauterine pathologies. When live birth rates of control group and the subgroups were compared, it was significantly higher in the subgroups (p < 0.05). When live birth rates of the subgroups were compared, there was a statistically significant difference in intrauterine pathology subgroup (p < 0.05). NNT measures showed that 13 OH interventions were needed to achieve one additional pregnancy [NNT 13.05; relative risk (RR) 1.418], while five pathologies had to be found and treated with OH to achieve one additional pregnancy (NNT 5; RR 1.962). CONCLUSION: Usage of OH can play an important role in detecting intrauterine pathologies in IVF patients. Therefore, it may have a positive impact on pregnancy outcome and treatment costs.

The utility of detecting ovulation to predict success in ovulation induction and intrauterine insemination cycles - a prospective observational study.

OBJECTIVES: The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may be limited by the absence of ovulation detection. The aim of this study was to evaluate the empirical use of ultrasonography and luteal phase progesterone (P4) as ovulation indicators and determine its effect on pregnancy outcome in OI-IUI cycles. MATERIAL AND METHODS: This prospective observational study, which was performed in a university setting, included 107 women with unexplained infertility. Following OI, IUI was performed 36 hours after human chorionic gonadotropin (hCG). P4 was measured 72-96 hours after hCG. At the same time, the appearance of ovaries and signs indicative of ovulation, which are decreased follicle dimensions, irregularity of follicular walls, and the presence of free fluid in the Douglas pouch, were noted. RESULTS: In 58 patients (54.2%), ovulation was detected at the P4 level of > 10 ng/mL. Eighty-nine patients had ultrasound images suggestive of ovulation. However, only 50 of these were confirmed ovulation as indicated using P4. Implantation was observed in a total of 13 patients (12.1%). All patients were in the ovulation detected group with P4 > 10 ng/mL (AUC: 0.750; p = 0.004). P4 of > 21.5 ng/mL detected successful ovulation and was strongly associated with implantation with 77% sensitivity and 61% specificity (OR: 9.9; 95% CI: 2.4-41.2). Body mass index (BMI) > 23.9 kg/m2 was a reliable anovulation indicator as a secondary outcome (AUC: 0.696; p = 0.02). CONCLUSIONS: In 45.8% of the patients, ovulation did not occur even with OI treatment. The association of progesterone measurement and ovarian ultrasound scanning between 72 and 96 hours after hCG treatment can be used to detect ovulation. In doing so, we can find the optimal treatment for patients with infertility in their next cycle.

Oxidative stress-mediated myocardiotoxicity of ciprofloxacin and ofloxacin in juvenile rats.

In this study, evaluation of the myocardiotoxic effect potential of ciprofloxacin and ofloxacin in juvenile rats and the role of oxidative stress in heart toxicity was conducted. Doses (25 and 50 mg/kg) of each drug were administered to the rats for 1 week. Serum biochemical cardiotoxicity parameters and tissue malondialdehyde and nitric oxide levels were measured. All measured parameters were found elevated in the drug-treated rats, being the highest in the 50-mg/kg ofloxacin-treated rats. Ciprofloxacin and ofloxacin may cause myocardiotoxicity by inducing the oxidative stress in the heart, and nitric oxide is partly responsible for this toxicity.

Matrix metalloproteinases are possible targets in monocrotaline-induced pulmonary hypertension: investigation of anti-remodeling effects of alagebrium and everolimus.

OBJECTIVE: In our study, sildenafil alone and everolimus or alagebrium in combination with sildenafil were investigated in terms of their additional therapeutic and anti-remodeling activity in monocrotaline-induced pulmonary hypertension (PH) model in rats. In particular, the inter-relationships between PH and matrix metalloproteinases (MMPs) were investigated. METHODS: The pulmonary artery responses of male Sprague Dawley rats were recorded using myography, and the quantities and activities of MMPs were analyzed in homogenates of the pulmonary arteries and lungs by enzyme-linked immunosorbent assays, activity assays, and gelatin zymography techniques. RESULTS: Our results indicated that the therapeutic effects of sildenafil were accompanied by its suppressor effects on MMP activity. It was also shown that everolimus or alagebrium in combination with sildenafil showed additional regulatory effects on MMPs as well as functional responses on pulmonary artery pressure. Therefore, the enzymes in the MMP superfamily are likely to be target molecules for the treatment of PH. CONCLUSION: In conclusion, MMPs were involved in the pathogenesis of PH, and our results suggested that the addition of everolimus or alagebrium to sildenafil therapy may be beneficial in PH. Our results indicated that agents that limit pulmonary vascular hypertrophy and inflammation via their anti-remodeling effects significantly ameliorate mortality and morbidity in PH.

Cervical priming before diagnostic operative hysteroscopy in infertile women: a randomized, double-blind, controlled comparison of 2 vaginal misoprostol doses.

The aim of this study was to evaluate the efficacy of vaginal misoprostol for cervical priming at doses of 200 mcg and 400 mcg, 12 to 15 hours before diagnostic office hysteroscopy (OH) without anesthesia in patients with infertility. Sixty infertile patients requiring a diagnostic office hysteroscopy for investigation of infertility were included in the study. The patients were randomly allocated into 3 vaginally administered misoprostol groups: (1) control group, (2) 200-mcg dose group, and (3) 400-mcg dose group. Misoprostol significantly facilitated the procedure of OH: cervical entry was easier; procedural time was shorter; baseline cervical width was larger; and pain scoring was lower in the misoprostol groups compared with the control group. Increasing the dose of misoprostol from 200 mcg to 400 mcg did not improve the effect on cervical dilation. Misoprostol is a promising analog to use for cervical priming before OH. Since doses of 200 mcg and 400 mcg vaginal misoprostol 12 hours before the OH both have proven to be effective regimens, 200 mcg may be preferred. However, before routine clinical usage, further research is needed through large, randomized, controlled trials powered to detect a difference in complications to determine whether misoprostol reduces complications in OH.

Tranexamic acid: a potential adjunct to resectoscopic endometrial ablation.

Abnormal uterine bleeding (AUB) is a substantial cause of ill health in women worldwide. In this study, our aim was to evaluate the effectiveness of endometrial ablation using a modified urologic resectoscope along with tranexamic acid in AUB. Sixty patients were enrolled in this study. All patients underwent resectoscopic surgery. Patients were randomly divided into two groups. Group 1 (n = 30) received 500 mg of tranexamic acid. Group 2 (n = 30) served as the control group and underwent surgery without the administration of tranexamic acid. Total pictorial blood loss assessment chart (PBAC) scores were significantly lower postoperatively (152.14 ± 9.65 versus 6.6 ± 0.90; P < 0.001). When stratified by the administration of tranexamic acid, the number of patients with a postoperative day 1 PBAC score ≤15 was higher in the tranexamic group (19 versus 13), whereas the number of patients with a post operative day 1 PBAC score >15 was lower in the tranexamic group (11 versus 17), but the differences were not statistically significant (P > 0.05). AUB is a complex disease that may need repeated treatments. In expert hands, the treatment rate of resectoscopic surgery seems acceptable. However, some patients may require additional interventions, like repeated surgery, hysterectomy, or a drug therapy in the long run. Introduction of tranexamic acid as a potential adjunct to rollerball endometrial ablation may present an interesting option that requires additional well-designed studies before firm conclusions can be made.