Epididymal sonographic findings in infertile males with isolated asthenozoospermia and their correlation with seminal plasma l-carnitine: An observational study.

OBJECTIVES: The present study aimed to show epididymal sonographic findings in infertile males with isolated asthenozoospermia as well as their correlation with seminal plasma l-carnitine. METHODS: Eighty married men were recruited in the study. Fifty infertile men with isolated asthenozoospermia and 30 fertile controls with normal semen parameters were included. Semen analysis was done with estimation of seminal plasma l-carnitine level. Scrotal ultrasonography was used as the diagnostic method for assessing epididymal morphology. RESULTS: Epididymal heterogeneous echogenicity was significantly higher in the infertile group compared to the controls. Whereas homogeneous epididymal echotexture and seminal plasma l-carnitine levels were significantly higher in the controls compared to the infertile patients. Interestingly, it was observed that within each group, seminal l-carnitine and sperm total motility were significantly higher in those with homogeneous rather than heterogeneous epididymal echotexture. CONCLUSIONS: Our study demonstrated a significant association between epididymal echo-texture, seminal plasma l-carnitine and sperm motility. Thus, we recommend performing epididymal sonographic evaluation as one of the basic investigations for infertile men.

Efficacy of Docetaxel and Oxaliplatin Regimen as a Second-Line Therapy for Patients with Advanced Pancreatic Adenocarcinoma.

BACKGROUND AND AIM OF WORK: Pancreatic cancer is the deadliest of the 21 most common cancers, largely because it is often identified at a late stage, we aimed to determine the control rates, and PFS for patients who received docetaxel-oxaliplatin regimen as a 2nd line therapy. PATIENTS AND METHODS: Twenty-five patients with advanced cancer pancreas progressed or failed on 1st line treatments and justified the inclusion criteria were eligible to receive Docetaxel 75 mg/m2 over 1h iv infusion on day 1, Oxaliplatin 80 mg/m2 over 2 h iv infusion on day 2, the cycle was repeated every 3 weeks for 6-8 cycles unless disease progression or severe toxicity appeared. RESULTS: No patients achieved complete response (CR), and the control rate (control rate = partial response (PR = 6/25, 24%) + stable disease (SD = 9/25, 36%) was 60% while disease progression (DP) was demonstrated in (10/25) 40% of patients, the median PFS was 7 ± 0.777 ms (95% confidence interval: 5.467-8.524 ms), grade 3 neutropenia, fatigue, diarrhea, and vomiting were developed in 12%, 8%, 12% and 8% of patients respectively. CONCLUSIONS: Docetaxel-oxaliplatin regimen was an active regimen in advanced cancer pancreas based on our encouraging results without occurrence of grade four toxicities.

Lower Transcranial Doppler Flow Velocities in Sickle Cell Anemia Patients on Hydroxyurea: Myth or Fact.

Transcranial Doppler (TCD) detects stroke risk in patients with sickle cell anemia (SCA). Hydroxyurea therapy has the ability to induce increased levels of fetal hemoglobin in sickle cells thus decreasing tendency for red cell sickling. This study aimed to evaluate TCD findings in SCA patients on hydroxyurea and correlate the time-averaged mean velocity (TAMV) with their hematological parameters. Forty SCA patients of both sexes, aged 16-22 years with no history of stroke were screened with TCD for an elevated TAMV, divided into: Group T (20 patients on blood transfusion); and Group H (20 patients on daily hydroxyurea). For all, full medical history, clinical examination, hemoglobin, hematocrit, leukocytes, platelets, fetal hemoglobin and sickling test, in addition TCD to describe the pattern of cerebral blood flow abnormalities were done. TAMV in all cerebral arteries were significantly higher in Group T than Group H, the highest TAMV (147.5 ± 57.09 cm/s) was found in the right middle cerebral artery and correlated negatively with hematocrit in Groups H (P < 0.001). There were 2 (10%) abnormal TAMV results and 5 (25%) conditional in Group T, while all results were normal in Group H. Hydroxyurea therapy may lower TCD velocities and prevent the risk of primary stroke in SCA patients.