Effects of dietary fermented Saccharomyces cerevisiae extract (Hilyses) supplementation on growth, hematology, immunity, antioxidants, and intestinal health in Nile tilapia.

This study investigated the effects of dietary supplementation with the product Hilyses on growth performance, feed utilization, nutrient composition, hematological parameters, serum biochemistry, immune function, antioxidant status, and digestive enzyme activity in juvenile Nile tilapia (Oreochromis niloticus, initial body weight 4.24 ± 0.01 g). The fish were fed diets supplemented with Hilyses at concentrations of 0, 1, 2, or 3 g/kg for a period of 8 weeks. The results showed that supplementation with Hilyses at levels up to 2 g/kg diet significantly improved final body weight, weight gain, specific growth rate, feed efficiency ratio, protein efficiency ratio, apparent protein utilization, and energy utilization compared to the control diet without Hilyses. Carcass crude protein content and moisture were significantly higher in Hilyses-fed groups, while crude lipid content decreased at the 3 g/kg supplementation level. Hilyses supplementation enhanced various hematological parameters, including increased red blood cell count, total leukocyte count, hemoglobin concentration, hematocrit, and mean corpuscular volume. Serum biochemistry and immune function markers like total protein, albumin, complement component C3, IgM, and IgG were significantly elevated in the 2 and 3 g/kg Hilyses groups. Antioxidant enzyme activities (catalase, glutathione peroxidase, total superoxide dismutase) were enhanced, and lipid peroxidation was reduced, in the 2 g/kg Hilyses group. Digestive enzyme activities, particularly protease and lipase, were also improved with Hilyses supplementation. Histological examination showed reduced lipid deposition in the liver and increased branching of intestinal villi at the 2 g/kg Hilyses level. Overall, these results indicated that dietary Hilyses supplementation at 2 g/kg diet optimizes growth, feed utilization, nutrient composition, hematology, immunity, antioxidant status, and digestive function in juvenile Nile tilapia.

A promising microbial α-amylase production, and purification from Bacillus cereus and its assessment as antibiofilm agent against Pseudomonas aeruginosa pathogen.

BACKGROUND AND AIM: The purpose of the current study is to isolate a heavily amylase-producing bacteria of the genus Bacillus from soil samples, optimize the production of the enzyme, purify it, and evaluate its activity against biofilm-producing bacteria. A total of 12 soil samples were collected and screened for promising Bacillus species with good amylolytic activity. Isolation was done by serial dilution and plating technique and amylolytic activity was determined by starch agar plate method. Among the 12 Bacillus isolates recovered from soil samples, 7 showed positive α-amylase production. The best isolate that recorded the greatest amylolytic activity was selected for further studies. This isolate was identified by 16S rRNA sequencing as Bacillus cereus and registered under gene bank accession number OP811897. Furthermore, the α-amylase enzyme was produced by a submerged fermentation technique using best production media and partially purified by ammonium sulfate and chilled ethanol and molecular weight had been determined by SDS-PAGE gel electrophoresis. The production of α-amylase was optimized experimentally by one-factor at a time protocol and statistically by Plackett-Burman design as well as RSM CCD design. Data obtained from OFAT and CCD revealed that α-amylase activities were 1.5- and twofold respectively higher as compared to un-optimized conditions. The most significant factors had been identified and optimized by CCD design. RESULTS: Among the eleven independent variables tested by PBD, glucose, peptone, (NH4)2SO4, and Mg SO4 were the most significant parameters for α-amylase production with an actual yield of 250U/ml. The best physical parameters affecting the enzyme production were incubation time at 35 °C, and pH 5.5 for 48 h. The partially purified enzyme with 60% ammonium sulphate saturation with 1.38- fold purification showed good stability characteristics at a storage temperature of 4 °C and pH up to 8.5 for 21 days. Antibiofilm activity of purified α-amylase was determined against Pseudomonas aeruginosa (ATCC 35659) by spectrophotometric analysis and CLSM microscopic analysis. Results demonstrated biofilm inhibition by 84% of the formed Pseudomonas biofilm using a microtiter plate assay and thickness inhibition activity by 83% with live/Dead cells percentage of 17%/83% using CLSM protocol. CONCLUSIONS: A highly stable purified α-amylase from B. cereus showed promising antibiofilm activity against one of the clinically important biofilm-forming MDR organisms that could be used as a cost-effective tool in pharmaceutical industries.

Efficiency analysis of cellular/LiFi traffic offloading.

Data offloading is a promising low-cost and power-efficient solution for the expected high demands for high-speed connectivity in the near future. We investigate offloading efficiency in a cellular/light fidelity (LiFi) network. This offloading efficiency is a measure of the ratio of traffic carried by the LiFi network to the total traffic carried by both LiFi and cellular networks. We consider the two scenarios of opportunistic and delayed offloading. Effects of user density, user mobility, LiFi-signal blocking, and channel characteristics are investigated. We use Zemax to simulate LiFi channels in the proposed model. Based on our results, delayed offloading can achieve up to 60% offloading efficiency while opportunistic offloading achieves up to 18% offloading efficiency.

Underwater localization system based on visible-light communications using neural networks.

Underwater localization using visible-light communications is proposed based on neural networks (NNs) estimation of received signal strength (RSS). Our proposed work compromises two steps: data collection and NN training. First, data are collected with the aid of Zemax OpticStudio Monte Carlo ray tracing software, where we configure 40,000 receivers in a $100\;{\rm m} \times 100\;{\rm m}$ area in order to measure the channel gain for each detector in seawater. The channel gains represent the input data set to the NN, while the output of the NN is the coordinates of each detector based on the RSS intensity technique. Next, an NN system is built and trained with the aid of Orange data mining software. Several trials for NN implementations are performed, and the best training algorithms, activation functions, and number of neurons are determined. In addition, several performance measures are considered in order to evaluate the robustness of the proposed network. Specifically, we evaluate the following parameters: classification accuracy (CA), area under the curve (AUC), training time, testing time, F1, precision, recall, logloss, and specificity. The corresponding measures are as follows: 99.1% for AUC and 98.7% for CA, F1, precision, and recall. Further, the performance results of logloss and specificity are 7.3% and 99.3% respectively.

On the performance of adaptive hybrid MQAM-MPPM scheme over Nakagami and log-normal dynamic visible light communication channels.

In this paper, we introduce the idea of using adaptive hybrid modulation techniques to overcome channel fading effects on visible light communication (VLC) systems. A hybrid $ M $M-ary quadrature-amplitude modulation ($ M{\rm QAM} $MQAM) and multipulse pulse-position modulation (MPPM) technique is considered due to its ability to make gradual changes in spectral efficiency to cope with channel effects. First, the Zemax optics studio simulator is used to simulate dynamic VLC channels. The results of Zemax show that Nakagami and log-normal distributions give the best fitting for simulation results. The performance of $ M{\rm QAM} $MQAM-MPPM is analytically investigated for both Nakagami and log-normal channels, where we obtain closed-form expressions for the average bit-error rate (BER). The optimization problem of evaluating the hybrid modulation technique settings that lead to the highest spectral efficiency under a specific channel status and constraint of outage probability is formulated and solved using an exhaustive search. Our results reveal that the adaptive hybrid scheme improves system spectral efficiency compared to ordinary QAM and MPPM schemes. Our results reveal that the adaptive hybrid scheme improves system spectral efficiency compared to ordinary QAM and MPPM schemes. Specifically, at low average transmitted power, $ - 32\;{\rm dBm} $-32dBm, the adaptive hybrid scheme shows 280% improvement in spectral efficiency compared to adaptive versions of ordinary schemes. At higher power, $ - 20\;{\rm dBm} $-20dBm, 6.5% and 725% improvement are obtained compared to ordinary QAM and ordinary MPPM, respectively. Also, the adaptive hybrid scheme shows great improvement in average BER and outage probability compared to ordinary schemes. The hybrid scheme shows 28%, 34%, and 38% improvement, respectively, for $ m = 1,2,3 $m=1,2,3 for Nakagami channels at $ {\rm BER}{ = 10^{ - 3}} $BER=10-3. Also, the outage probability of hybrid schemes of $ {\rm BER}{ = 10^{ - 3}} $BER=10-3 shows 30% and 14% better performance than ordinary $ M{\rm QAM} $MQAM and MPPM schemes, respectively.

NLoS underwater VLC system performance: static and dynamic channel modeling.

In this paper, the impact of water channels under different communication link parameters is studied for underwater visible light communication (UVLC). The objective is to highlight the best results for non-line of sight (NLoS) communication links. In addition, NLoS links are studied under different parameters: LED colors, viewing angle, receiving angle, and data rates. The results are obtained and plotted using MATLAB simulation. The performance of the received power is first measured at different wavelengths and data rates. Then, the best results are further investigated at different viewing angles and receiving angles. The obtained results show that using cyan color provides more depth for the NLoS case, as well as a low bit error rate compared to the other colors. Most of the literature is concerned with unpractical configurations in underwater scenarios, such as an empty sea or assuming no human-object or blockage environment. We use the practical setup in Zemax Optics Studio to allow a precise description of ray tracing and high order of reflections inside a sea water environment. The channel impulse response (CIR) is obtained for static channel modeling, including a blockage environment to evaluate the best transmitters in sea water. Also, we are able to compare the average delay and the average delay spread of the source colors. The reflection characteristics of the sea water are considered as wavelength dependent. The CIR obtained by Zemax Solver and MATLAB indicates that cyan is the best source in sea water for different LED chips. Moreover, other previous studies assume perfect alignment scenarios between divers, which is not practical and not suitable for real channel gain results. Accordingly, we present a comprehensive dynamic channel modeling and characterization study for UVLC. Our study is based on Zemax programming language (ZPL) combined with Zemax Optics Studio. Using ZPL enables us to apply a mobility algorithm for divers and measure the channel gain variations due to random motion. We introduce a dynamic motion in a single-input single-output scenario and a single-input multiple-output scenario in the presence of blockage divers. Statistical analyses are studied for the appropriate distributions that can fit the data with various transmitter and receiver specifications. All dynamic scenarios are performed using cyan color in sea water, as it is proven to have satisfactory performance. The statistical results are beneficial for further analysis. As case studies, we consider various underwater scenarios, and the resulting parameters of statistical distributions can be used for future analysis in UVLC dynamic environments.

Effect of local wound infiltration with ketamine versus dexmedetomidine on postoperative pain and stress after abdominal hysterectomy, a randomized trial.

BACKGROUND AND OBJECTIVES: Postoperative pain and stress elicit hormonal changes. We aimed at comparing the effects of wound infiltration with ketamine versus dexmedetomidine on postoperative pain and stress response. METHODS: This double-blinded study included ninety patients scheduled for total abdominal hysterectomy and were randomly assigned into three groups to receive local wound infiltration with 40 mL of 0.25% bupivacaine (group C), plus 2 mg/kg ketamine (group K) or 2 µg/kg dexmedetomidine (group D). Primary outcome was postoperative morphine consumption; secondary outcomes included first request of analgesia, VAS scores at rest and movement (VAS-R/M) and side effects. Serum cortisol, prolactin and glucose levels at baseline, pre-infiltration, 6 and 24 h postoperatively were measured. RESULTS: Rescue analgesia was less in K (6.80 ± 3.19 mg) and D (8.39 ± 3.86 mg) compared to C (13.33 ± 4.01 mg) (p < 0.05). First request of analgesia was delayed in K (7.60 ± 4.16 h) and D (6.00 ± 3.73 h) compared to C (4.20 ± 1.13 h) (p < 0.05). Both VAS and R/M were significantly lower in K (all over 24 h) and D (for 8 and 4 h, respectively) compared to C. Stress markers were significantly lower in K and D compared to C at 6 and 24 h, and in K compared to D at 24 h (p < 0.05). CONCLUSIONS: Local wound infiltration with ketamine or dexmedetomidine added to bupivacaine had an opioid-sparing effect, delayed first request of rescue analgesia, and attenuated postoperative stress response, especially with ketamine in patients underwent total abdominal hysterectomy.

Enhanced therapeutic benefit of quercetin-loaded phytosome nanoparticles in ovariectomized rats.

Quercetin, a dietary flavonol phytoestrogen, has many health benefits but it is poorly absorbed when administered orally. To improve its bioavailability, we prepared quercetin-loaded phytosome nanoparticles (QP) using the thin film hydration method. The prepared nano-formulations were characterized using different techniques. Transmission electron microscopy revealed the homogeneously spherical, well and uniformly dispersed, nano-sized nature of QP. Dynamic light scattering measurements of QP (70 ± 7.44 nm) also confirmed this. Stability of the formed nanoparticles was established via zeta potential determination. The prepared QP exhibited very high encapsulation efficiency (98.4%). The estrogenic activity of QP, concerning inflammation, oxidative stress, bone, lipid profile, blood glucose level and weight gain, was investigated in ovariectomized rat model using 10 and 50 mg/kg/day oral doses for 4 weeks. Treatment with QP showed significant increase in serum calcium, inorganic phosphorus and glutathione content. Whereas, it significantly decreased serum alkaline phosphatase, acid phosphatase, malondialdehyde level, tumor necrosis factor-alpha and glucose level and improved lipid profile. Consequently, the results obtained confirm the superiority of QP over free quercetin at the same doses as a promising hormone replacement therapy.

Impact of vitamin D receptor gene polymorphisms in pathogenesis of Type-1 diabetes mellitus.

BACKGROUND: Type 1 diabetes mellitus (TIDM) results from an immune-mediated destruction of insulin-producing-cells in the pancreatic islets of Langerhans. There are clear differences in immunogenetic predisposition to type1 diabetes among countries. Studies have indicated that vitamin D supplementation in early childhood decreases the risk of TIDM. Vitamin D exerts its action via the nuclear vitamin D receptor (VDR), which shows an extensive polymorphism. VDR gene polymorphisms have been associated with altered gene expression or gene function. Four single nucleotide polymorphisms (SNPs) in the VDR gene produce variation in four recognition sites. These recognition sites variants include Fok I, Bsm I, Apa I and Taq I. AIM OF THE STUDY: TO investigate the relationship between VDR gene polymorphisms (at positions Taq I and Apa I) and the incidence of TIDM in Egyptian peoples. SUBJECTS AND METHODS: This study included 74 patients with type 1 DM in addition to 28 healthy age and sex matched control subjects. All of them were subjected to full history taking and clinical examination. Three ml of venous blood were withdrawn from each patient at fasting and postprandial times and used for genomic DNA extraction, estimation of Hb A1C, as well as, fasting and postprandial C-peptide and blood glucose levels. RESULTS: Apa I recognition site was found in low frequency in diabetic patients (14/74) 18.9% while, its frequency was high (16/28) 57.1% among normal subjects. Taq I has two recognition sites. The first was found at nucleotide number 293 that was found in a frequency of (2/28) 7.1% in normal non-diabetic individuals while it was detected in (14/74) 18.9% in diabetic patients. The second Taq I recognition site was found at nucleotide number 494 without any differences between diabetic and normal individuals. CONCLUSION: This study indicates that there is an association between VDR genetic polymorphism and incidence of TIDM in Egyptian patients.

Air quality in Ain Shams University Surgery Hospital.

Through air sampling, it was possible to evaluate microbial contamination in environments at high risk of infection, and to check the efficiency of ventilation system and the medical team's hygiene procedures. This study measured the concentration of particulate matter (PM) 2.5 or less microns and microbiological organisms in operating rooms (OR), intensive care units (ICU) and emergency rooms (ER) in Ain Shams University Surgery Hospital, and to assess ventilation characteristics in operating rooms in the hospital. The passive air sampling was done from ICUs, ORs, and ERs in Ain Shams University Surgery Hospital. Also for each operating room, an observational checklist was done to record other factors that may affect air quality in the room. The evaluated air quality indices were: suspended (PM) 2.5 micrometer or less, culture media and microbial identification of bacteria and fungi, and temperature and relative humidity. The results showed that the highest mean found for bacterial (105.70±30.49) and fungi concentration (7.50±5.30) was in ER. The three settings did not differ statistically as regard levels of PM 2.5, temperature, and relative humidity. A positive correlation exits between bacteria and fungi concentration on one hand and relative humidity on the other. Diphteroid, CONS, MRSA, S. aureus, and Anthracoid were the most frequent isolated bacterial types, while Penicillium and Asperigillus fumigatus were the most frequent isolated fungi. In operating rooms, the percent of unmasked persons present and the temperature positively influence the bacterial count, while ventilation condition is negatively influencing fungi count, and the number of persons present in the operating room positively affects the PM level.

[Changes in growth patterns and intracellular calcium concentrations in aspergillus awamori treated with amphotericin B].

Growth patterns and intracellular Ca2+ concentrations in the mutant strain Aspergillus awamori 66A, containing a recombinant aequorin gene were studied in the presence of a permeabilizing fungicidal agent amphotericin B. The cell response, i.e., changes in the growth and development of the fungus (initiation of spore germination, mycelial growth, and intensity ofsporulation) was dose-dependent. Low concentrations of amphotericin B (2.5 microM) stimulated spore germination: the number of germinating spores was 2-3 times higher than in the control (without the fungicide). At higher amphotericin concentrations (20 microM) spore germination was inhibited. Amphotericin B had a dose-dependent effect on mycelial growth and sporulation intensity on solid Vogel medium. Intracellular Ca2+ concentrations in the presence of amphotericin B were investigated using the luminescence of the photoprotein aequorin. High concentrations of amphotericin B (10 and 20 microM) were shown to cause an instantaneous increase in Ca2+ concentrations, compared to the control and lower amphotericin concentration (2.5 microM). Ca2+ concentrations remained elevated throughout the experiment and correlated with the inhibition of mycelial growth and development.

Pulmonary embolism caused by cement leakage during percutaneous vertebroplasty. A case report of successful conservative management.

Percutaneous vertebroplasty (PV) is considered a minimally invasive procedure, yet cement leakage into the circulation may result in serious complications. Here, we are reporting a case of pulmonary embolism following PV for treatment of osteoporotic compression vertebral fracture.

Acromioclavicular joint reconstruction using anchor sutures: surgical technique and preliminary results.

A number of surgical procedures have been described for reconstruction of the disrupted acromioclavicular (AC) joint. Among these is the use of anchor sutures tied over a small button plate. The present study aims to evaluate the preliminary results with this technique in 15 patients with a mean age of 31 years (range: 19-48 years). The shoulder was evaluated clinically using the Constant-Murley Shoulder Score, and radiologically. Indication for surgery was Rockwood type IV-V AC joint dislocation. All patients returned to work within a mean time of 11.2 weeks (range 8-18) postoperatively. The mean Constant-Murley Shoulder Score at last follow-up was 92.8. Postoperative radiographs confirmed anatomic reduction in all patients. Residual subluxation occurred in one patient and dislocation occurred in another. All patients except one were satisfied with the results in terms of functional performance and cosmetic appearance. In conclusion, considering its low morbidity, unnecessary hardware removal and minimal complications from breakage or migration of metal implants, this technique appears to offer a good alternative in AC joint stabilization.

Food composition and feeding habits of some fresh water fishes in various water systems at Abbassa, Egypt, with special reference to snails transmitting diseases.

Study of feeding habits of freshwater fishes collected from ponds at World Fish Center (ICLARM) showed that the African catfish, Clarias gariepinus and Forskal catfish, Bagras bayad had the highest proportion of full stomachs (31-58% & 44-45% respectively). In cichlid fishes, the rate of full stomachs was much lower, being 0.0-12.5% and showed higher incidence of empty stomachs that varied from 37.5% for Oreochromis niloticus to 78.3% for Sarotherodon galilaeus. Food items were analyzed by the percentage of point assessment (P%), abundance (N%) and frequency of occurrence (F%). Results of the three methods of analyses (Index of relative importance, I.R.I) emphasized the importance of plants (1214.7) as a major food resource in the stomach of Nile tilapia, O. niloticus followed by shell fragments (628.5), whereas, snail soft bodies were the main food category in the diet of hybrid tilapia O. niloticus x O. aureus (2539.3). Shell fragments (652) and snail soft bodies (296.9) were the 1st in relative importance as foods of O. aurea. In case of S. galillae, shell fragments (338) came 2nd in I.R.I. after plants (559). Present investigation shows that shell fragments were represented by 11.1% and 15.1% in the diet of African catfish, C. gariepinus by (N%) and (P%) methods, however, they came as the second food item in its diet by I.R.I (1237.3). According to F% method, both shell fragments and Crustacea were present in the diet of C. gariepinus considerable proportions each of 47.4%. Shell fragments were represented by low proportions in the diet of B. bayad 3.9, 2.1 and 22.2 by N%, P% and F% respectively.

Correlation between snails and fish in fish ponds of World Fish Center (ICLARM) with special reference to snail vectors of schistosomiasis and fascioliasis.

The abundance of snail species in earthen fish ponds, irrigation and drainage canals at World Fish Center (ICLARM) in descending order was Bellamya unicolor (50.89%) > Physa acuta (18.94%) > Cleopatra bulimoides (7.6%) > Lanistes carinatus (6.73%) > Bulinus truncatus (5.19%) > Melanoides tuberculata (4.83%) > Lymnaea natalensis (3.14%) > Gabbiella senaariensis (0.9%) > Biomphalaria alexandrina (0.55%) > Lym naea truncatula (0.4%) > Planorbis planorbis and Succinea cleopatra (0.33%) > Ferrissia isseli (0.18%). Dead snails constituted about 5.19% of all the collected specimens. There were dramatic decrease in the total number of pulmonates in fish ponds which contained only Tilapia sp., and a very small number of cat fish, whereas the numbers of prosobranchia snails were much higher in these ponds. In fish ponds which accommodated a variety of fish species, the most dominant snail was B. unicolor followed by L. carinatus. However, pulmonate snails were absent in these ponds. B. truncatus was the only snail species found in concrete tank which contained only young tilapias with a very small size (5-8 cm in standard length). In irrigation canals, the number of snails and diversity was much higher than those in fish ponds. Out of 191 snails collected from inlet irrigation canal, 71 were dead, but in the outside irrigation canals, seven out of 564 snails were dead. P. acuta was absent in all examined fish ponds, but it was alive and in a high number (497 snails) in the outside irrigation canals. The number of snails collected from Bahnasawy drain was remarkably low (128 snails), however the diversity of snails was much higher compared to those in fish ponds and irrigation canals. Snail populations were stable with constant recruitment of young to adult snails for all the studied species.

A new synthesis of oxadiazole, thiazolidinone, N-phthalimidoamino carbonyl and arylidene derivatives with potential antimicrobial activity.

Condensation of carbohydrazide derivatives Ia, b with dimethyl acetylenedicarboxylate and acetylenedicarboxylic acid yielded benzofuran derivatives II a-d. Reaction of Ib with aromatic aldehydes formed products III a-d. Treatment of compounds III a-d with mercaptoacetic acid yielded the cyclocondensation products (IVa-d). Phthalic anhydride reacted with compounds (Ia, b)to form products (Va, b). It has been found that both khellin and visnagin (VIa, b)react with aromatic aldehydes to give arylidene derivatives (VIIa-e). Condensation of diphenyl nitrilamine with 2-arylidene furochromones VII derivatives afforded cyclo-adducts (VIII a-i). The antibacterial activities of the selected compounds were tested against Staphylococcus aureus, B. subtilis, E. coli, Pseudomonas, Salmonella and Erwinia with good results.

Studies on the megatrypanum trypanosomes of the Egyptian bat (Pipistrellum kuhli) from Sohag Governorate, Egypt.

Out of 150 Egyptian bats (Pipistrellus Kuhli) hunted in the premises of Sohag City, 60 (40%) were harbouring typanosomes of the subgenus Megatypanum (Hoare, 1964). They were T. M. heybergi (Rodhian, 1923), T. M. possoai (Dean and Sugary, 1963) and T. M. magadermae (Wenyon, 1990).

Effect of restorative treatment on mutans streptococci and IgA antibodies.

PURPOSE: Streptococcus mutans has been implicated as the major causative agent of dental caries. Although restorative treatment for caries is thought to temporarily eliminate the carious challenge, there are few reports of alterations in salivary mutans streptococci (MS) numbers and no reports of changes in salivary IgA antibody to S. mutans following restorative treatment. METHODS: This study investigated the effects of treatment in 12 caries-active children. RESULTS: Numbers of MS decreased slightly from pre- to postrestoration levels in six subjects and increased in five subjects. However, there were no significant differences in pre-to postrestoration numbers of total oral streptococci, MS, the percentage of MS/total oral streptococci, salivary IgA antibody levels to S. mutans, or correlations between bacterial counts and IgA antibody levels. CONCLUSIONS: These results indicate that successful restorative treatment does not alter mutans streptococcal numbers and suggest the need for more effective methods for reducing the cariogenic challenge.

Treatment of varicocele: a comparative study of conventional open surgery, percutaneous retrograde sclerotherapy, and laparoscopy.

OBJECTIVES: To present our experience with the results of three different methods of treatment of idiopathic varicoceles. METHODS: A total of 301 patients with 417 varicoceles were retrospectively assigned into three groups according to the method of treatment. Group 1 included 94 patients with 131 varicoceles treated by open surgery. Group 2 consisted of 120 patients with 163 varicoceles treated by percutaneous retrograde sclerotherapy, and in group 3, 87 patients with 123 varicoceles were treated by laparoscopic varicocelectomy. Of all patients, 222 (73.8%) were closely followed up with clinical and Doppler ultrasound examinations 6 and 12 months after the treatment. Seminal analysis was carried out before treatment and repeated in 172 patients with subfertility or infertility 4 to 6 months after treatment. RESULTS: Patients in the three treatment groups were balanced regarding the different variables. The mean operative time was significantly shorter among patients with open surgery. The cost of sclerotherapy is one fourth to one fifth that of surgery and the cost of laparoscopy is double. Sclerotherapy was successful in 96 (82.8%) of 116 left varicoceles and in only 24 (51%) of 47 right varicoceles. The recurrence rate at follow-up was not significantly different among the three groups. The recurrence rate increased progressively with the increase of varicocele size from grade I to grade III in all groups. The overall incidence of postoperative complications was significantly higher among patients with open surgery. Postoperative spermiogram showed a significant increase in the density and motility and a significant reduction in the percentage of abnormal forms in all groups. The pregnancy rate was approximately similar in all groups. CONCLUSIONS: First, sclerotherapy is best used for isolated left-sided varicoceles. Second, laparoscopy is the treatment of choice for bilateral varicoceles. Finally, open surgery still has a role in isolated right-sided varicoceles and in left-sided cases with failed sclerotherapy.