CYP24A1 Gene Expression in Spermatozoa of Human and Other Oxidation Level Controlling Enzymes as Biomarkers of Infertility.

Background: Physiologically, the spermatozoa are exposed to reactive oxygen species (ROS), and those ROS can strongly affect sperm's function through sperm capacitation. However, producing a high level of ROS reduces the sperm anti-oxidation system that may cause infertility, especially in cases with normal sperm count. Purpose: To investigate the expression of the CYP24A1 gene in human spermatozoa and other oxidation-related biomarkers, including vitamin E, ROS, and catalase as added tools to predict male infertility. Method: The study included 50 infertile men and 50 young volunteers from the general Iraqi population. Blood samples were drawn from all included men, and semen samples were collected by masturbation. All the samples of semen were investigated for CYP24A1 expression, and routine semen analysis was performed. In addition, the serum was separated and used to assess other biochemical parameters, namely catalase, reactive oxygen species, and vitamin E, which were measured by ELISA. Results: Serum ROS levels were higher in patients than control groups, while the serum catalase and vitamin E levels were significantly lower in patients than controls. CYP24A1 gene expression is significantly higher in infertile men with sperm count higher than 70 million and reaches twofold times the control. Conclusion: CYP24A1 gene expression is significantly higher in infertile men and can be used as a marker of infertility, especially in infertile males with normal sperm count. At the same time, the serum catalase and vitamin E levels were significantly lower, which can be added as tools to predict male infertility..

Can Fetal Heart Lie? Intrapartum CTG Changes in COVID-19 Mothers.

Background: COVID-19 infection has raised multiple concerns in pregnant mothers; many questioned the risk of vertical transmission and the implication on the feto-maternal outcome. Cardiotocogrm (CTG) is the principal method to observe intrapartum fetal well-being. This paper aims to verify intrapartum CTG changes seen in seropositive COVID-19 mothers versus healthy controls and looks into their relation to subsequent delivery mode and neonatal outcome. Methods: A case-control study recruited 90 pregnant women at the labor word of AL Yarmouk Teaching Hospital. All were term pregnancy admitted for delivery. They were grouped into 2: seropositive COVID-19 confirmed by real-time RT-PCR test (30/90) and healthy controls (60/90). We recorded their demographic criteria, laboratory results, CTG changes, delivery mode, and indication. Results: COVID-19 cases showed significantly higher pulse rate, temperature, and leukocyte counts. Cesarian deliveries (CS) were higher in cases versus healthy controls (70 % vs. 53.3 %) and P = 0.45. Analysis of the CS indications showed that abnormal fetal heart tracing accounts for 33.3 % versus 15.6 % (P-value = 0.015) for cases versus healthy controls. 60 % of COVID-19 cases exhibited abnormal CTG changes versus 19.4 % in healthy controls. These changes were primarily fetal tachycardia and reduced variabilities. Conclusions: The higher incidence of abnormal CTG in COVID-19 cases, alongside infection signs and symptoms, underlies the exaggerated inflammatory reactions inside the pregnant mother. These inflammatory reactions are the main causes of CTG changes and higher CS rates. Therefore, obstetricians are advised to optimize the maternal condition to rectify reactive CTG changes rather than proceeding into urgent CS. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01663-6.

The value of Neutrophil gelatinase-associated lipocalin and Neutrophil / Lymphocyte Ratio in the diagnosis of preeclampsia and its severity.

Many hypotheses underlie the pathogenesis of preeclampsia. This study aims to evaluate Neutrophil gelatinase-associated lipocalin (a marker of immune hypothesis) and Neutrophil / Lymphocyte ratio (a marker of inflammation) in the diagnosis of preeclampsia and its severity and to determine the correlation between them.Study design : This randomized case-control study involved 132 pregnant women ; 88 were diagnosed with PE (divided into non-severe and severe groups), and 44 healthy pregnant women as a control group. Results : The mean serum level of NGL was significantly higher in PE (535.37 ±â€…158.61 ng / ml for severe PE, 522.5 ±â€…106.3 ng / ml for non-severe PE, and 161.96 ±â€…17.48 ng / ml for the control group). The ROC Curve NGL criteria of more than 204.4 ng / ml showed 100% sensitivity and specificity in both severe and non-severe cases versus control. The N / L ratio showed a significant difference (5.81 ±â€…5.24 for severe PE, 4.1 ±â€…3.41 for non-severe PE, and 3.89 ±â€…1.79 for the control group), but the ROC curve criterion was not significant. Both showed a non-significant positive correlation. Conclusion : NGL is an excellent diagnostic factor, whereas N / L might have lower diagnostic performance compared with NGL. Both are related independently to the pathophysiology of PE. J. Med. Invest. 68 : 321-325, August, 2021.

COVID-19 in Pregnancy: Implication on Platelets and Blood Indices.

OBJECTIVE: To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. METHODS: A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. RESULTS: Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker. CONCLUSION: The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

OBJETIVO: Descrever as alterações hematológicas, em particular os índices plaquetários em gestantes com doença coronavírus 2019 (COVID-19) em comparação com gestantes saudáveis. MéTODOS: Estudo caso-controle retrospectivo realizado no Hospital Universitário Al Yarmouk, em Bagdá, Iraque envolvendo 100 gestantes, 50 com DNA viral positivo para COVID-19 (grupo caso) e 50 com resultados negativos (grupo controle); ambos os grupos foram submetidos a uma avaliação hematológica completa. RESULTADOS: Entre as principais variáveis hematológicas analisadas, os índices plaquetários, nomeadamente o volume plaquetário médio (VPM) e a largura de distribuição plaquetária (PDW), apresentaram diferenças estatisticamente significativas (VPM: 10,87 ± 66,92 fL para o grupo caso versus 9,84 ± 1.2 fL para o o grupo controle; PDW: 14,82 ± 3,18 fL para o grupo caso versus 13,3 ± 2,16 fL para os controles). O valor de critério da curva de característica de operação do receptor (ROC) para PDW em um ponto de corte de> 11,8 fL mostrou um marcador diagnóstico fraco, enquanto o do VPM em um valor de corte de> 10,17 fL mostrou um bom marcador de diagnóstico. CONCLUSãO: O MPV e PDW são significativamente afetados por esta infecção viral, mesmo em casos confirmados assintomáticos, e recomendamos que ambos os parâmetros sejam incluídos no painel de diagnóstico desta infecção.

Maternal and perinatal outcome of pregnant women with COVID 19, a tertiary centre experience in Iraq - A Case Series.

The clinical course of 26 cases from the time of hospital admission till discharge from Al Yarmouk teaching hospital, Baghdad from June to August 2020 was analysed. The results will reflect on the maternal and perinatal consequences of confirmed cases of Corona Virus Disease during pregnancy. The disease was scored as severe in 11.53% while one case was critical and ended with maternal and foetal death. Five (19.3%) cases delivered vaginally and 15(57.69%) delivered by Caesarean section, three of them were delivered preterm due to disease severity. The mean foetal weight was 2.4 kg, APGAR score at 5 min was 6.8, foetal growth restriction 2(7.69%) cases, intrauterine foetal death 3(11.53%), neonatal care unit admission 5(19.23%) and neonatal death in one of the preterm babies. The study showed significant rates of severe maternal and foetal complications which should be considered when managing such a disorder.

COVID-19 in Pregnancy: Implication on Platelets and Blood Indices / COVID-19 na gravidez: implicações nas plaquetas e índices sanguíneos

Abstract Objective To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. Methods A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. Results Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker. Conclusion The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

Resumo Objetivo Descrever as alterações hematológicas, em particular os índices plaquetários em gestantes com doença coronavírus 2019 (COVID-19) em comparação com gestantes saudáveis. Métodos Estudo caso-controle retrospectivo realizado no Hospital Universitário Al Yarmouk, em Bagdá, Iraque envolvendo 100 gestantes, 50 com DNA viral positivo para COVID-19 (grupo caso) e 50 com resultados negativos (grupo controle); ambos os grupos foram submetidos a uma avaliação hematológica completa. Resultados Entre as principais variáveis hematológicas analisadas, os índices plaquetários, nomeadamente o volume plaquetário médio (VPM) e a largura de distribuição plaquetária (PDW), apresentaram diferenças estatisticamente significativas (VPM: 10,87±66,92 fL para o grupo caso versus 9,84±1.2 fL para o o grupo controle; PDW: 14,82±3,18 fL para o grupo caso versus 13,3±2,16 fL para os controles). O valor de critério da curva de característica de operação do receptor (ROC) para PDW em um ponto de corte de> 11,8 fL mostrou um marcador diagnóstico fraco, enquanto o do VPM emumvalor de corte de> 10,17 fL mostrou um bom marcador de diagnóstico. Conclusão OMPVe PDWsão significativamente afetados por esta infecção viral, mesmo em casos confirmados assintomáticos, e recomendamos que ambos os parâmetros sejam incluídos no painel de diagnóstico desta infecção.

Electro-encephalogram as predictor of eclampsia.

OBJECTIVE: To assess the efficacy of using electroencephalographic changes for predicting eclampsia. METHODS: The observational case-control study was conducted in the Obstetrics Department of Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from April 1, 2016, to April 1, 2018, and comprised women with singleton pregnancy who had 24-40 weeks of gestation. They were divided into two groups as preeclamptic cases and normotensive controls. The groups were compared regarding electroencephalographic changes and the development of eclampsia in those with abnormal changes. Data was analysed using EVEIWS 9. RESULTS: Of the 100 subjects, 50(50%) were in each of the two groups. There was no significant difference between the groups in terms of demographic and clinical data (p>0.05) except blood pressure (p<0.05). Among the patients, 31(62%) had electroencephalographic abnormalities, while among the controls 3(6%) showed abnormal waves (p<0.001)..Focal sharp and intermittent slow waves were the commonest abnormal waves detected but the percentages of these waves between the groups were statistically not significant (p>0.05). CONCLUSIONS: Women with preeclampsia were found to have electroencephalographic abnormalities which might predict an eclamptic fit.