Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature.

This study aims to explain microscopic replantation in a rare case of a wholly amputated penis after prolonged ischemia. A 36-year-old patient underwent microscopic replantation of the penis after 9 hours. The penis was completely amputated due to self-mutilation. Microvascular replantation was performed after pre-operative preparation. On the second day after surgery, congestion was observed in the penis, and three sessions of leech therapy were conducted each time the leeches were placed for 30 minutes and then detached by themselves. The patient was referred to a psychiatrist to continue treatment after discharge from the hospital. Penile amputation is a rare situation and has different causes. There are various treatments to repair the amputated penis, which are both microvascular and microvascular. The microsurgery methods have shown the best results. In the present case, due to microsurgical artery repair and the early start of leech therapy, there was limited and predictable necrosis in the area of the penoscrotal junction flap, which underwent debridement and skin graft. Complete amputation of the penis is a rare phenomenon. Efforts should be made to perform the replantation surgery as soon as possible. The venous outflow is an essential factor in the success of penile re-implantation, and completely restored vascular and sensory function in this case. Early initiation of psychological care to control underlying disease leads to further cooperation of the patient to handle complications and avoid the recurrence of self-injury.

Influence of dietary L-carnitine and lysine-methionine levels on reproductive performance and blood metabolic constituents of breeder ducks.

The present study aimed to evaluate the influence of dietary supplementation of different levels of L-carnitine and/or lysine-methionine (Lys-Met) on reproductive performance of breeder ducks. Three L-carnitine (0, 75 and 150 mg/kg) and three lysine-methionine (100%, 110% and 120% above the NRC (Nutrient requirements of poultry, 1994, National Academy Press) recommendations) levels were fed to 180 breeder ducks (144 females and 36 males) in a completely randomized design for 49 days. Laying performance and reproductive traits were evaluated; additionally, uric acid, total protein total, triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were assessed. The Lys-Met above 100% NRC (Nutrient requirements of poultry, 1994, National Academy Press) recommendations with or without L-carnitine improved feed utilization (p < .05). Furthermore, Lys-Met above 100% recommendations without L-carnitine improved egg fertility and hatchability. Fertility and hatchability improved in breeders fed on L-carnitine with 120% Lys-Met (p < .05). Serum glucose increased and total cholesterol reduced on 100% Ly-Met without L-carnitine or 110% Ly-Met with 150 mg L-carnitine (p < .05). Glucose was reduced, while total cholesterol increased on 75 mg L-carnitine and 100% Lys-Met (p < .05). Increasing Lys-Met without L-carnitine reduced serum protein (p < .05). Albumin and ALT increased on 75 mg L-carnitine-100% Lys-Met and reduced on 150 mg L-carnitine-120% Lys-Met (p < .05). There were no interaction effects on globulin, uric acid and AST (p > .05). Thus, based on findings, breeder ducks responded to dietary Lys-Met more efficiently than L-carnitine; however, more research is needed to evaluate also economic aspects related to L-carnitine dietary supplementation.

Gastrointestinal bleeding due to gastrointestinal lipoma: A case report.

BACKGROUND: Lipomas are common harmless tumors that are created in the colon in the gastrointestinal tract. The aim of this study was to report a case study on gastrointestinal lipoma with GIB. CASE PRESENTATION: A 38-year-old man was admitted to the hospital because of gastrointestinal bleeding for two months in December 2017. He had abdominal pain, dyspeptic disorders, vomiting, melena, and intermittent hematemesis without significant weight loss. Upper gastrointestinal endoscopy indicated a large subepithelial lesion in the antrum of the stomach with near-normal mucosa. Endoscopic ultrasound (EUS) showed a large well-defined heterogeneous mass-like lesion in the antrum of the stomach. A subtotal gastrectomy was done in the patient. The histology results of the separated samples presented a gastric lipoma. CONCLUSION: Gastric lipoma is often yellowish. It might ulcerate and bleed, but it does so, only rarely. It most frequently occurs as a solitary and smooth mass in the gastric antrum.

Amniotic membrane dressing versus nitrofurazone-impregnated dressing in the treatment of second-degree burn wounds: a randomized clinical trial.

INTRODUCTION: Both the amniotic membrane biologic dressing and nitrofurazone-impregnated dressing are treatment options for burn wounds. OBJECTIVE: To compare the efficacy of these treatments in healing second-degree burns, a randomized clinical trial was conducted among patients with second-degree burns who had no comorbidities or history of addiction and were referred to a burn center in Urmia, Iran, between December 2017 and September 2019. MATERIALS AND METHODS: Patients were randomly assigned to one of 2 study groups. Wounds were dressed in either amniotic membrane covered with moistened gauze/petrolatum or nitrofurazone-impregnated gauze. Comparative groups were matched according to percentage of burn (total body surface area). The dressing application occurred once daily in the nitrofurazone group and once weekly in the amniotic membrane group. The study was conducted until all wounds healed. The study outcomes included the infection rate of the wound, pain severity related to dressing changes, dressing change frequency, epithelialization rate, hospitalization length of stay, morphine use, and scarring. Data were collected in real time by the researcher via observation, interview, examination of the patient, and, eventually, completion of a checklist. Analyzed quantitative and qualitative variables were reported as mean ± standard deviation and percentage (frequency). RESULTS: Each group included 35 participants (24 men, 11 women; age, 20.05 ± 3.60 years in the amniotic dressing group; and 20 men, 15 women; age, 21.60 ± 2.02 years in the nitrofurazone-impregnated gauze group). Assessment was performed on days 1, 7, 14, and 30 from the initial treatment and at discharge. No significant difference was noted in the rate of infection between the 2 groups. Epithelialization was complete (100%) by day 7 in the amniotic membrane group, versus 77% in the nitrofurazone group. Pain following dressing application, length of hospitalization, morphine use, and scarring at day 14 were significantly lower (P < .05) in the amniotic membrane group. CONCLUSIONS: This study indicated that the use of amniotic membrane dressing improved factors key to healing in second-degree burn wounds compared with nitrofurazone-impregnated dressing. Further research with a larger sample is warranted.

ZnO Q-dots as a potent therapeutic nanomedicine for in vitro cytotoxicity evaluation of mouth KB44, breast MCF7, colon HT29 and HeLa cancer cell lines, mouse ear swelling tests in vivo and its side effects using the animal model.

Nanoformulations derived from fine porous ZnO quantum dot nanoparticles (QD NPs) can offer strong potential medical applications; especially in cancer therapy. ZnO QD NPs was synthesized by sol-gel hydrothermal process, fast cold quenching and further smart surface functionalization methods to obtain ultrasmall size (1-4 nm) NPs. ZnO nanopolymer, a wetting agent, PEG co-solvent and water/oil emulsion stabilizer were considered in our nanofluid formulation. The resulting nanofluid was characterized by SEM, FTIR, photoluminescence, band gap energy, zeta potential and UV-Vis spectroscopy. The cytotoxic effects on the growth of four cancer cell lines were evaluated by MTT assay. The IC50 (µg/ml) values of 30, 41, 40 and 35 for KB44, MCF-7, HT29 and HeLa cells, respectively, after 48 h of nanoformulation treatment suggested the cytotoxic effect of this nanoformulation on these cell lines in a concentration-dependent manner (p < .05). ZnO nanofluid destroyed cancer cell lines more efficiently than the normal HFF-2 (IC50 = 105 µg/ml). The reduction in cell viability in response to ZnO nanofluid treatment induced apoptosis in the cultured cells. Skin sensitization test plus antibacterial activity were also measured. Side effect tests on 70 white mice in vivo resulted in only 3-4 abnormal situations in hepatic tissue section possibly due to the idiosyncratic drug reactions.

Reconstructing a Giant Frontal Osteoma With Porex.

Osteomas are the most common benign tumors of the paranasal sinuses. They are usually localized in the frontal sinus. Giant osteomas of the frontal sinuses are very rare but readily extend into the intraorbital or intracranial cavity, causing serious complications. This is a report of a 14 year-old boy with a bulging in frontal area and asymptomatic giant osteoma of the frontal sinuses. He had a history of minor trauma that had a bulging after 3 months. However, he referred to a plastic surgeon after 15 months. Computed tomography of the sinuses revealed a 3.5 × 6 cm extremely dense bony mass in the frontal sinus that extended into the left orbit and ethmoid sinus. A bicoronal frontal flap was raised with a V-shaped skin incision starting from the tragus placed 5 cm posterior to the hairline. The osteoma was resected completely in the frontal sinus and the anterior wall of frontal sinus was reconstructed with Porex. The patient has not had any complications until the time of writing this report. Titanium mesh may still be a valuable option, but Medpore Porex has shown to be quite effective in this case.

Prognostic value of mean platelet volume in patients undergoing elective percutaneous coronary intervention.

OBJECTIVE: We sought to determine the role of mean platelet volume (MPV) for predicting long-term outcomes of elective percutaneous coronary intervention (PCI). METHODS: On the basis of retrospective cohort study, we collected characteristics of 680 patients undergoing elective PCI from October 2005 to August 2010. The patients who had preoperative MPV were assessed for developing major adverse cardiac events (MACE) during 1-year follow-up. They were categorized into two groups including MPV <9.6 fL (n=89) and MPV ≥9.6 fL (n=92). Data were analyzed using t-test, chi-square test, Pearson correlation, receiver operating characteristic (ROC) curve and logistic regression. RESULTS: One-hundred eighty one patients (26.6%) met inclusion criteria. The MACE was observed in 29 patients (16%); and its rate in low- and high-MPV groups was 11.2% and 20.7%, respectively (p=0.084). MPV was significantly higher in the patients with left ventricular ejection fraction (LVEF) <40% compared with that of ≥40% (p<0.001). There were a significant and negative correlation between MPV and platelet count (r=-0.305, p<0.001), and significant and positive correlations between MPV and platelet distribution width (PDW) and platelet large cell ratio (P-LCR) (r=0.615, p<0.001 and r=0.913, p<0.001; respectively). The best MPV cut-off point was 9.25 fL; the sensitivity and specificity were 79% and 38%, respectively. Elevated MPV was the best predictor of MACE at 1-year follow-up (OR=11.359, 95% CI 2.481-51.994, p=0.002). CONCLUSION: The results indicate that preoperative MPV is an independent predictor of the MACE at 1-year follow-up in the patients undergoing elective PCI. Moreover, it may be useful for risk stratification in such cases.

Protective effect of ginger on gentamicin-induced apoptosis in testis of rats.

PURPOSE: Ginger, the rhizome of Zingiber officinale, is one of the most widely used spices for various foods and as an herbal medicine in Asian countries. It has been shown that ginger has antioxidant power. Gentamicin is an aminoglycoside antibiotic with a very broad spectrum against microbial pathogens, especially the gram-negative. Many studies revealed that gentamicin induces an oxidative stress-status in the testis by increasing free radical formation and lipid peroxidation. The present study was designed to investigate on the effects of Ginger as a natural anioxidant on testis apoptosis after treatment with gentamicin in rats. METHODS: In order to study the recovery effects of ginger on testis apoptosis after treatment with gentamicin 40 adult Wistar male rats were selected and randomly divided into four groups. Normal salin control (group I) (n=10), gentamicin control (group II), ginger control (group III) and gentamicin + ginger (group IV) each 10 rats. There was observation of negative effect of Gentamicin on testis histology in rats. RESULTS: The results revealed that there was a significant increase in apoptosis in group III when compared with other groups (P<0.05).However, ginger could decrease apoptosis in group IV that received 100mg/kg/rat of Ginger. CONCLUSION: Regarding the results, it is recommended that administration of ginger with gentamicin might be beneficial in men who receive gentamicin to treat infections.

The effects of electromagnetic field on the microstructure of seminal vesicles in rat: a light and transmission electron microscope study.

In the industrial world, almost everyone is unavoidably exposed to ambient electromagnetic field (EMF) generated from various technical and household appliances. Controversy exists about the effects of EMF on various tissues of the living bodies. Seminal vesicles as one of these accessory glands play an important role in natural seminal fluid formation and the effects of EMF on its tissue is worthy of investigation. In order to examine this 30 rat were selected and kept for one weeks in quarantine and 15 (experimental group) were exposed to 50 Hz (non-ionizing radiation) during postnatal life for 2 months. The materials were processed and observed under a light and transmission electron microscope. In the experimental rats epithelial and basal cells showed significant destructions presented by heterochromatin and dense nuclei. Cell debris and abnormal areas was recognizable in the stromal connective tissue. Obvious vacuolization was present within the epithelial cell cytoplasm and also between the cellular organelles. The nuclei of the endothelial cells of the blood vessels were more rigid and endothelial cell cytoplasm contained a lot of vacuoles and pinoctotic vesicles. The results suggested that EMF exposure may cause profound changes in the vesicle seminal tissues. Therefore exposure to EMF may result in pathological changes that lead to sub fertility and infertility.