A case of intra-abdominal gossypiboma diagnosed preoperatively by endoscopic ultrasound fine-needle-aspiration.

Gossypiboma is an extremely rare adverse event occurring post-surgery, where surgical gauze is left within the body. If aseptically retained, it can lead to the formation of granulation tissue through chronic inflammation and adhesion with surrounding tissues, potentially persisting asymptomatically for many years. While diagnosis of this condition has been reported through various imaging modalities such as abdominal ultrasound and computed tomography, cases not presenting with typical findings are difficult for preoperative diagnosis, and instances where it is discovered postoperatively exist. Particularly when in contact with the gastrointestinal tract within the abdominal cavity, differentiation from submucosal tumors of the digestive tract becomes problematic. This report describes the imaging characteristics of endoscopic ultrasound and the usefulness of endoscopic ultrasound-fine-needle-aspiration for tissue diagnosis in the preoperative diagnosis of intra-abdominal gossypiboma.

Effect of delignification on the adsorption of loofah sponge-based immobilized metal affinity chromatography adsorbent for His-tagged trehalose synthase.

The effect of delignification on the adsorption capacity of loofah sponge-based immobilized metal affinity chromatography adsorbents was investigated with recombinant His-tagged trehalose synthase as the model protein. Pretreatments with [EMIM][Ac] ionic liquid at 80 °C for 5 h and with sodium chlorite/acetic acid at 80 °C for 2 h were found effective for the removal of lignin, leading to a loss in biomass of 15.7% and 25.2%, respectively. Upon delignification, the metal chelating capacities of the loofah sponge-based adsorbents prepared with 5-h ionic liquid pretreatment (712 ± 82 µmole Cu(II)/g) and with 2-h sodium chlorite/acetic acid pretreatment (1012 ± 18 µmole Cu(II)/g) were 38% and 97% higher than that of the control (514 ± 55 µmole Cu(II)/g), adsorbent prepared with untreated loofah sponge, respectively. Results of protein adsorption study indicated that the Co(II)-loaded adsorbent prepared with 2-h sodium chlorite/acetic acid pretreatment exhibited the highest adsorption capacity and selectivity for the recombinant His-tagged trehalose synthase, giving a purification product with a specific activity of 7.62 U/mg protein. The predicted maximum adsorption capacity of the delignified loofah sponge-based adsorbent, 2.04 ± 0.14 mg/g, was 73% higher than that of the control.

Endogenous electric field coupling Mxene sponge for diabetic wound management: haemostatic, antibacterial, and healing.

Improper management of diabetic wound effusion and disruption of the endogenous electric field can lead to passive healing of damaged tissue, affecting the process of tissue cascade repair. This study developed an extracellular matrix sponge scaffold (K1P6@Mxene) by incorporating Mxene into an acellular dermal stroma-hydroxypropyl chitosan interpenetrating network structure. This scaffold is designed to couple with the endogenous electric field and promote precise tissue remodelling in diabetic wounds. The fibrous structure of the sponge closely resembles that of a natural extracellular matrix, providing a conducive microenvironment for cells to adhere grow, and exchange oxygen. Additionally, the inclusion of Mxene enhances antibacterial activity(98.89%) and electrical conductivity within the scaffold. Simultaneously, K1P6@Mxene exhibits excellent water absorption (39 times) and porosity (91%). It actively interacts with the endogenous electric field to guide cell migration and growth on the wound surface upon absorbing wound exudate. In in vivo experiments, the K1P6@Mxene sponge reduced the inflammatory response in diabetic wounds, increased collagen deposition and arrangement, promoted microvascular regeneration, Facilitate expedited re-epithelialization of wounds, minimize scar formation, and accelerate the healing process of diabetic wounds by 7 days. Therefore, this extracellular matrix sponge scaffold, combined with an endogenous electric field, presents an appealing approach for the comprehensive repair of diabetic wounds.

Solid-state Ru(bpy)32+ electrochemiluminescence sensor for trace detection of fenpropathrin using loofah sponge-like carbon nanofibers and CdS.

Loofah sponge-like carbon nanofibers (LF-Co,N/CNFs) were utilized as a carrier for Ru(bpy)32+, and then combined with CdS to create a novel solid-state electrochemiluminescence sensor capable of detecting trace amounts of fenpropathrin. LF-Co,N/CNFs, obtained through the high-temperature pyrolysis of ZIF-67 coaxial electrospinning fibers, were characterized by a loofah-like morphology and exhibited a significant specific surface area and porosity. Apart from serving as a carrier, LF-Co,N/CNFs also functioned as a luminescence accelerator, enhancing the system's luminescence efficiency by facilitating electron transmission and reducing the transmission distance. The inclusion of CdS in the luminescence reaction, in conjunction with Ru(bpy)32+, further boosted the sensor's luminescence signal. The resulting sensor demonstrated a satisfactory signal, with fenpropathrin causing significant quenching of the ECL signal. Under optimized conditions, a linear relationship between the signal quench value and fenpropathrin concentration in the range 1 × 10-12 to 1 × 10-6 M was observed, with a detection limit of 3.3 × 10-13 M (S/N = 3). This developed sensor is characterized by its simplicity, sensitivity, and successful application in detecting fenpropathrin in real samples. The study not only presents a straightforward detection platform for fenpropathrin but also introduces new avenues for the rapid determination of various food contaminants, thereby expanding the utility of carbon fibers in electrochemiluminescence sensors.

Impact of Microparticle Transarterial Chemoembolization (mTACE) on myeloid-derived suppressor cell subtypes in hepatocellular carcinoma: Clinical correlations and therapeutic implications.

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) play a pivotal role in immunosuppression and tumor progression in hepatocellular carcinoma (HCC). While various treatments like surgical resection, ablation, and radiotherapy have been studied for their effects on circulating MDSC frequencies in HCC patients, the findings remain inconclusive. Transarterial Chemoembolization (TACE) stands as the standard care for unresectable HCC, with Microparticle TACE (mTACE) gaining prominence for its capacity to induce significant tumor necrosis. However, the immunological ramifications of such pathological outcomes are scarcely reported. METHODS AND RESULTS: This study aims to elucidate the alterations in MDSC subtypes, specifically monocytic MDSCs (mMDSCs) and early-stage MDSCs (eMDSCs), post-mTACE and to investigate their clinical correlations in HCC patients. A cohort comprising 75 HCC patients, 16 liver cirrhosis patients, and 20 healthy controls (HC) was studied. Peripheral blood samples were collected and analyzed for MDSC subtypes. The study also explored the associations between MDSC frequencies and various clinical parameters in HCC patients. The frequency of mMDSCs was significantly elevated in the HCC group compared to liver cirrhosis and HC. Importantly, mMDSC levels were strongly correlated with aggressive clinical features of HCC, including tumor size, vascular invasion, and distant metastasis. Post-mTACE, a marked reduction in mMDSC frequencies was observed, while eMDSC levels remained stable. CONCLUSIONS: Our findings underscore the critical role of mMDSCs in HCC pathogenesis and their potential as a therapeutic target. The study also highlights the efficacy of mTACE in modulating the immunosuppressive tumor microenvironment, thereby opening new avenues for combinatorial immunotherapeutic strategies in HCC management.

Flexible and robust polyaniline/cross-linked collagen sponge with fibrils network structure as a piezoresistive sensing material.

The polyaniline/cross-linked collagen sponge (PANI/CCS) was synthesized by polymerizing PANI onto the collagen skeleton using mesoscopic collagen fibrils (CFs) as building blocks, serving as a piezoresistive sensing material. The structure and morphology of PANI/CCS were characterized using scanning electron microscopy (SEM), Fourier infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and thermal analysis (TA). The mechanical properties of PANI/CCS could be controlled by adjusting the CFs content and polymerization conditions. PANI/CCS treated with pure water exhibited exceptional compressive elasticity under 1000 compression cycles, demonstrating a wide strain range (0-85 %), rapid response time (200 ms), recovery time (90 ms), and high sensitivity (6.72 at 40-50 % strain). The treatment of the ionic liquid further improved the elasticity and the strain sensing range (0-95 %). The presence of PANI nanoparticles and mesoscopic collagen fibrils imparted antibacterial properties, stability in solvents, and biodegradability to PANI/CCS. Utilizing PANI/CCS as a piezoresistive sensing material enabled monitoring human movement behavior through the assembled sensor, showing significant potential for flexible wearable devices.

Metagenomic Insights Reveal Unrecognized Diversity of Entotheonella in Japanese Theonella Sponges.

Numerous biologically active natural products have been discovered from marine sponges, particularly from Theonella swinhoei, which is known to be a prolific source of natural products such as polyketides and peptides. Recent studies have revealed that many of these natural products are biosynthesized by Candidatus Entotheonella phylotypes, which are uncultivated symbionts within T. swinhoei. Consequently, Entotheonella is considered an untapped biochemical resource. In this study, we conducted metagenomic analyses to assess the diversity of Entotheonella in two T. swinhoei Y and two T. swinhoei W (Y and W referring to the yellow and white interior of the sponge, respectively), after separating filamentous bacteria using density gradient centrifugation. We obtained five Entotheonella metagenome-assembled genomes (MAGs) from filamentous bacteria-enriched fractions. Notably, one of these MAGs is significantly different from previously reported Entotheonella variants. Additionally, we identified closely related Entotheonella members present across different chemotypes of T. swinhoei. Thus, our metagenomic insights reveal that the diversity of Entotheonella within Theonella sponges is greater than previously recognized.

Glucosamine sulfate-loaded nanofiber reinforced carboxymethyl chitosan sponge for articular cartilage restoration.

Cartilage is severely limited in self-repair after damage, and tissue engineering scaffold transplantation is considered the most promising strategy for cartilage regeneration. However, scaffolds without cells and growth factors, which can effectively avoid long cell culture times, high risk of infection, and susceptibility to contamination, remain scarce. Hence, we developed a cell- and growth factor-dual free hierarchically structured nanofibrous sponge to mimic the extracellular matrix, in which the encapsulated core-shell nanofibers served both as mechanical supports and as long-lasting carriers for bioactive biomass molecules (glucosamine sulfate). Under the protection of the nanofibers in this designed sponge, glucosamine sulfate could be released continuously for at least 30 days, which significantly accelerated the repair of cartilage tissue in a rat cartilage defect model. Moreover, the nanofibrous sponge based on carboxymethyl chitosan as the framework could effectively fill irregular cartilage defects, adapt to the dynamic changes during cartilage movement, and maintain almost 100 % elasticity even after multiple compression cycles. This strategy, which combines fiber freeze-shaping technology with a controlled-release method for encapsulating bioactivity, allows for the assembly of porous bionic scaffolds with hierarchical nanofiber structure, providing a novel and safe approach to tissue repair.

Nitrification characteristics and microbial community changes during conversion of freshwater to seawater in down-flow hanging sponge reactor.

In recirculating aquaculture systems (RAS), maintaining water quality in aquaculture tanks is a paramount factor for effective fish production. A down-flow hanging sponge (DHS) reactor, a trickling filter system used for water treatment of RAS that employs sponges to retain biomass, has high nitrification activity. However, nitrification in seawater RAS requires a long start-up time owing to the high salinity stress. Therefore, this study aimed to evaluate the nitrification characteristics and changes in the microbial community during the conversion of freshwater to seawater in a DHSreactor fed with ammonia-based artificial seawater. The total ammonia nitrogen concentration reached 1.0 mg-N·L-1 (initial concentration 10 mg-N·L-1) within 11 days of operation, and nitrate production was observed. The 16 S rRNA gene sequence of the DHS-retained sludge indicated that the detection rate of the ammonia-oxidizing archaeon Candidatus Nitrosocosmicus decreased from 23.9 % to 14.0 % and 25.8-17.6 % in the upper and lower parts of the DHS reactor, respectively, after the introduction of seawater. In contrast, the nitrite-oxidizing bacteria Nitrospira spp. increased from 0.1 % to 9.5 % and from 0.5 % to 10.5 %, respectively. The ammonia oxidation rates of 0.12 ± 0.064 and 0.051 ± 0.0043 mg-N·g-MLVSS-1·h-1 on the 37th day in the upper and bottom layers, respectively. Thus, nitrification in the DHS reactor performed well, even under high-salinity conditions with short operational days. This finding makes the transition from freshwater to saltwater fish in the RAS system simple and economical, and has the potential for early start-up of the RAS.

Enhancing the porosity of chitosan sponges with CBD by adding antimicrobial violacein.

Given the growing interest in non-toxic materials with good anti-inflammatory and antimicrobial mechanical properties, this work focuses on preparing chitosan sponges with violacein and cannabis oil crosslinked with dialdehyde chitosan. The sponge was tested for its physicochemical and biological properties, presenting a high swelling rate, good thermal stability, and satisfactory mechanical properties. The obtained sponge's water vapor transmission rate was 2101 g/m2/day and is within the recommended values for ideal wound dressings. Notably, adding violacein favorably affected the material's porosity, which is essential for dressing materials. In addition, studies have shown that the designed material interacts with human serum albumin and exhibits good antioxidant and anti-inflammatory properties. The antibacterial properties of the prepared biomaterial were assessed using the Microtox test against A. fisherii (Gram-negative bacterium) and S. aureus (Gram-positive bacterium). The investigated material provides potential therapeutic benefits due to the synergistic action of chitosan, violacein, and cannabis oil so that it could be used as a dressing material. The natural origin of the substances could provide an attractive and sustainable alternative to traditional commercially available dressings.

Effective use of fibrinogen concentrate in a pediatric splenic injury requiring transcatheter arterial embolization.

Correction of coagulation is a crucial aspect of trauma care. While there are reports highlighting the effectiveness of fibrinogen concentrate in severe trauma cases with coagulopathic complications, literature on its use in pediatric cases remains limited. This paper discusses the case of a 5-year-old male presenting with a splenic injury and associated coagulopathy. We administered fibrinogen concentrate to enhance his coagulability prior to performing transcatheter arterial embolization utilizing gelatin sponges, aiming for optimal hemostasis. Post-administration, the patient's fibrinogen levels improved significantly, leading to successful hemostasis and a positive clinical outcome.

Low-cost, reliable, and highly efficient removal of COD and total nitrogen from sewage using a sponge-filled trickling filter.

Development of low-cost and reliable reactors demanding minimal supervision is a need-of-the-hour for sewage treatment in rural areas. This study explores the performance of a multi-stage sponge-filled trickling filter (SPTF) for sewage treatment, employing polyethylene (PE) and polyurethane (PU) media. Chemical oxygen demand (COD) and nitrogen transformation were evaluated at hydraulic loading rates (HLRs) ranging from 2 to 6 m/d using synthetic sewage as influent. At influent COD of ∼350 mg/L, PU-SPTF and PE-SPTF achieved a COD removal of 97% across all HLRs with most of the removal occurring in the first segments. Operation of PE-SPTF at an HLR of 6 m/d caused substantial wash-out of biomass, while PU-SPTF retained biomass and achieved effluent COD < 10 mg/L even at HLR of 8-10 m/d. The maximum Total Nitrogen removal by PE-SPTF and PU-SPTF reactors was 93.56 ± 1.36 and 92.24 ± 0.66%, respectively, at an HLR of 6 m/d. Simultaneous removal of ammonia and nitrate was observed at all the HLRs in the first segment of both SPTFs indicating ANAMMOX activity. COD removal data, media depth, and HLRs were fitted (R2 > 0.99) to a first-order kinetic relationship. For a comparable COD removal, CO2 emission by PU-SPTF was 3.5% of that of an activated sludge system.

A bioactive composite sponge based on biomimetic collagen fibril and oxidized alginate for noncompressible hemorrhage and wound healing.

The study focuses on developing a bioactive shape memory sponge to address the urgent demand for short-term rapid hemostasis and long-term wound healing in noncompressible hemorrhage cases. A composite sponge was created by spontaneously generating pores and double cross-linking under mild conditions using biomimetic collagen fibril (BCF) and oxidized alginate (OA) as natural backbone, combined with an inert calcium source (Ca) from CaCO3-GDL slow gelation mechanism. The optimized BCF/OACa (5/5) sponge efficiently absorbed blood after compression and recovered to its original state within 11.2 ± 1.3 s, achieving physical hemostatic mechanism. The composite sponge accelerated physiological coagulation by promoting platelet adhesion and activation through BCF, as well as enhancing endogenous and exogenous hemostatic pathways by Ca2+. Compared to commercial PVA expanding hemostatic sponge, the composite sponge reduced bleeding volume and shortened hemostasis time in rat liver injury pick and perforation wound models. Additionally, it stimulated fibroblast migration and differentiation, thus promoting wound healing. It is biodegradable with low inflammatory response and promotes granulation tissue regeneration. In conclusion, this biocomposite sponge provides multiple hemostatic pathways and biochemical support for wound healing, is biologically safe and easy to fabricate, process and use, with significant potential for clinical translation and application.

Preovulatory follicular dynamics and ovulatory events following the use of GnRH 84 h after medroxyprogesterone acetate sponge removal in postpartum buffaloes.

Herein, we evaluated the effects of Gonadotropin hormone-releasing hormone (GnRH) administration 84 h after medroxyprogesterone acetate (MAP) sponge removal on follicular growth, ovulation timing, and pregnancy per artificial insemination (AI) in cosynchronized postpartum Nili Ravi buffaloes. In this study, 58 Nili Ravi postpartum buffaloes (DIM = 103 ± 1.64) were randomly divided into two treatment groups (n = 29/treatment): GnRH-TAI-84 and TAI-84. All buffaloes were administered a MAP sponge for seven days. Upon MAP sponge removal, all the subjects received prostaglandin F2α (PGF2α), and Timed AI (TAI) was performed 84 hours after sponge removal. In the GnRH-TAI-84 group, the buffaloes received GnRH alongside insemination, whereas in the TAI-84 group, the buffaloes were inseminated without GnRH administration. Follicle diameter and blood estradiol levels were measured every 6 h from 72-108 h after MAP sponge removal. The animals were checked for pregnancy using ultrasonography 40 days after AI. Animals subjected to the GnRH-TAI-84 protocol had a higher follicular growth rate and preovulatory follicle size than those in the TAI-84 group. The follicular diameter was also larger in animals that received GnRH-TAI-84 than in those that received TAI-84 90 and 96 h after MAP sponge removal. Buffaloes in the GnRH-TAI-84 group had lower estradiol concentrations at 90, 96, 102, and 108 h than those in the TAI-84 group. Ovulation in GnRH-TAI-84 buffaloes occurred 11 h earlier than that in buffaloes from the TAI-84 group. A shorter interval between AI and ovulation in GnRH-TAI-84 buffaloes (14 h vs. 25 h) led to greater pregnancies per AI (62% vs. 17%) compared to buffaloes from the TAI-84 group.

Pyrrololactam alkaloids with IL-6 inhibitory activities from the sponge Phakellia fusca collected in the South China Sea.

Sixteen undescribed pyrrololactam alkaloids, including five 2-bromopyrrole-ε-lactam (1a, 1b, 4a, 4b and 5), two 3-bromopyrrole-ε-lactam (9 and 10), eight pyrrole-ε-lactam (2a-3 and 6a-8), and one pyrrole-δ-lactam alkaloids (11), along with three previously reported compounds (12-14) were isolated from the marine sponge Phakellia fusca collected in the South China Sea. The planar structures were determined by NMR and MS analyses, while the absolute configurations were clearly elucidated by comparing the experimental and calculated ECD spectra. Compounds 2a, 2b, 4a-7b, 10, 12 and 13 exhibited anti-inflammatory activity in inhibiting the production of inflammatory cytokines IL-6 in LPS-induced RAW264.7 macrophages.

The topical application of Sphistin12-38 in combination with sponge spicules for the acne treatment.

We demonstrated for the first time that a marine-derived antimicrobial peptide (AMP), Sph12-38, exhibit high antimicrobial activity against P. acnes with a minimum bactericidal concentration (MBC) value of 7 µM. Meanwhile, Sph12-38 has no significant cytotoxicity to human keratinocytes (HKs) at its high concentration (33.5 µM). The topical application of sponge Haliclona sp. spicules (SHS) dramatically enhanced the skin penetration of Sph12-38 up to 40.9 ± 5.9% (p < 0.01), which was 6.1 ± 0.9-fold higher than that of Sph12-38 alone. Further, SHS resulted in the accumulation of most Sph12-38 in viable epidermis and dermis. Further, the combined use of Sph12-38 and SHS resulted in a cure rate of 100% for rabbit ear acne treatment in vivo for two weeks, while the one induced by other groups was 40%, 0% and 0% for SHS alone, Sph12-38 alone and control group, respectively. The strategy of combined using AMP and SHS can also be applied in a rational designed topical delivery system for the management of other deep infection of the skin. The effectiveness of SHS by itself on the treatment of acne was also demonstrated by clinical trials. After 14 days of treatment by 1% SHS gel. The number of skin lesions decreased by 51.4%.

Beautoide A, an Anti-Osteoclastogenic Steroid from Beauveria sp. NBUF147 Associated with an Irciniidae Sponge from the Marine Mesophotic Zone.

Mesophotic coral ecosystems (MCEs), located at depths ranging from 30-150 m, host some of the most diverse yet least explored marine bioresources, particularly significant for the discovery of new bioactive molecules. The fungus Beauveria sp. NBUF147, associated with an Irciniidae sponge from the mesophotic zone at a depth of 82 m, underwent chemical investigation that led to the identification of one new sterol, beautoide A (1), and one reported sterol, 3ß,5α,9α-trihydroxy-(22E,24R)-ergosta-7,22-dien-6-one (2). Their structures were determined from analysis of spectroscopic data and X-ray crystallography. Evaluation of biological activity in prednisolone-induced osteoporotic zebrafish showed that 1 was anti-osteoclastogenic in vivo at 3.0 µM.

Crystal structures, phase transition, and Hirshfeld surface analyses of the bromide and chloride congeners of aqua[2,4,6-tris(pyridin-4-yl)-1,3,5-triazine]zinc(II) halide.

During the course of exploring crystallization conditions in generating metal-organic frameworks (MOFs) for use in the crystalline sponge method, two discrete metal-organic complexes, namely, aqua[2,4,6-tris(pyridin-4-yl)-1,3,5-triazine]zinc(II) bromide, [Zn(C18H12N6)(H2O)]Br2, and aqua[2,4,6-tris(pyridin-4-yl)-1,3,5-triazine]zinc(II) chloride, [Zn(C18H12N6)(H2O)]Cl2, were encountered. Structures in the orthorhombic space group Pnma (No. 62) for the bromide congener at 299 K and the chloride congener at 100 K were obtained. A phase transition for the bromide congener occurred upon cooling from 299 to 100 K, yielding a crystal polymorph with four domains that exhibits monoclinic P21/m space-group symmetry (No. 11), which arises from conformational changes. The main intramolecular contacts that contribute to the crystal packing in all observed structures are H...H, Halide...H/H...Halide, C...H/H...C, and N...H/H...N. Intramolecular hydrogen bonding between the Zn-bound water and non-Zn-bound pyridyl N atoms is a prominent feature within the three-dimensional networks. Aromatic π-stacking between the non-Zn-bound pyridine rings and contacts involving the halide ligands further stabilize the crystal packing.

A shape memory cationized chitosan sponge loaded with thrombin for high-effective hemostasis and antibacterial activity.

This study presents a thrombin-loaded cationized chitosan (TCCS) sponge with highly effective hemostatic and antibacterial activity. The TCCS sponge, prepared using a multistep method, features a porous structure, favorable mechanical properties, excellent water absorption ability, and shape recovery triggered by water or blood. The TCCS sponge exhibited strong antibacterial activity against Methicillin-resistant Staphylococcus aureus and Escherichia coli. Additionally, it demonstrated enhanced procoagulant and hemostatic efficacy in rat tail amputation and rat liver perforation wound models compared to commercial hemostats. Furthermore, the sponge exhibited favorable biocompatibility and biosafety. These findings suggest that the TCCS sponge has substantial potential for practical applications in managing severe hemorrhages and bacterial infections.

Evaluation of the efficiency of estrus synchronization protocols combined with natural service and ultrasonography on ewe reproductive performance during non-breeding season.

Background: Estrus synchronization is an important assisted reproductive technology to improve the reproductive performance in ewes. Various protocols have been used with variable success rates, however; literature regarding field applicable estrus synchronization is meagre. Aims: The present study was designed with the aim to evaluate the estrus synchronization protocols on reproductive performance in ewes using different hormones. Methods: Experimental ewes were divided randomly into three groups (n=15). Ewes of all groups received intravaginal sponge for 12 days. Subsequently, NP4-GnRH and NP4-eCG groups received 8 µg of buserelin acetate or 200 IU of eCG intramuscularly, respectively on day 12 whereas NP4-Insulin group received insulin 0.2 IU/kg body weight subcutaneously for three consecutive days started on the day of sponge removal. Estrus detection commenced 24 h after sponge removal in NP4-GnRH and NP4-eCG groups and 24 h following last injection of insulin in NP4-Insulin group. The ewes in estrus were separated and pen mated. The conception rate was determined by ultrasonography. Results: The estrus response and conception rates were 71.43, 92.86 and 53.85%, and 70.00, 84.61, and 71.43%, respectively in NP4-GnRH, NP4-eCG, and NP4-Insulin groups. The lambing rates were the same as the conception rates. The single and multiple birth rates were 71.41, 36.36 and 60.0%, and 28.57, 63.64, and 40.0% whereas prolificacy was 128.57, 190.91, and 140.00%, respectively in NP4-GnRH, NP4-eCG, and NP4-Insulin groups. Conclusion: In conclusion, the estrus synchronization protocol including intravaginal progesterone sponge and eCG was found to be more effective under field conditions.