Vitamin D and vitamin D receptor polymorphism in Asian adolescents with primary dysmenorrhea.

BACKGROUND: The expression of vitamin D receptor in the normal endometrium and ovaries supports the role of vitamin D in local immunity and inflammatory cytokines regulation. OBJECTIVE: This study aimed to detect the relation between serum 25(OH)D and primary dysmenorrhea in Asian Adolescents. METHODS: Two hundred and five (205) adolescents complaining of primary dysmenorrhea (study group) were compared in this prospective study to matched controls (210 controls) after informed consent following the Helsinki Declaration. After thorough evaluation, including a thorough history and pelvic ultrasound examination, blood samples were collected from the studied adolescents to measure serum 25(OH)D and for vitamin D receptor TaqI (rs731236) genotyping. The studied adolescents' data were analyzed using the Pearson's correlation to detect the relation between serum 25(OH)D and primary dysmenorrhea (primary outcome). The secondary outcome measures the odds of primary dysmenorrhea in Asian adolescents with vitamin D receptor TaqI (rs731236) polymorphism. RESULTS: The serum 25(OH)D was significantly lower in the studied-dysmenorrhea group compared to controls (16.17 ± 7.36 versus 17.65 ± 6.36 ng/ml, respectively), (P = 0.01). The correlation analysis showed a significant negative correlation between the serum 25(OH)D and visual analogue scale of dysmenorrhea (r = -0.9003, P < 0.0001). The studied-dysmenorrhea cases with vitamin D receptor T/t and t/t genotypes had significantly lower serum 25(OH)D (16.7 ± 8.05 and 14.4 ± 4.1 ng/ml, respectively) compared to controls (18.97 ± 6.7 and 21.4 ± 2.45 ng/ml, respectively), (P = 0.02 and 0.004, respectively). The VDR T/t and t/t polymorphisms significantly increase the odds of primary dysmenorrhea (OR 1367.2, P < 0.0001 and OR 106.2, P = 0.001, respectively). CONCLUSION: The serum 25(OH)D was significantly lower in the studied-dysmenorrhea group compared to controls. The studied-dysmenorrhea cases with VDR T/t and t/t TaqI genotypes had significantly lower serum 25(OH)D compared to controls. The VDR T/t and t/t polymorphisms significantly increase the odds of primary dysmenorrhea.

Seaweed for climate mitigation, wastewater treatment, bioenergy, bioplastic, biochar, food, pharmaceuticals, and cosmetics: a review.

The development and recycling of biomass production can partly solve issues of energy, climate change, population growth, food and feed shortages, and environmental pollution. For instance, the use of seaweeds as feedstocks can reduce our reliance on fossil fuel resources, ensure the synthesis of cost-effective and eco-friendly products and biofuels, and develop sustainable biorefinery processes. Nonetheless, seaweeds use in several biorefineries is still in the infancy stage compared to terrestrial plants-based lignocellulosic biomass. Therefore, here we review seaweed biorefineries with focus on seaweed production, economical benefits, and seaweed use as feedstock for anaerobic digestion, biochar, bioplastics, crop health, food, livestock feed, pharmaceuticals and cosmetics. Globally, seaweeds could sequester between 61 and 268 megatonnes of carbon per year, with an average of 173 megatonnes. Nearly 90% of carbon is sequestered by exporting biomass to deep water, while the remaining 10% is buried in coastal sediments. 500 gigatonnes of seaweeds could replace nearly 40% of the current soy protein production. Seaweeds contain valuable bioactive molecules that could be applied as antimicrobial, antioxidant, antiviral, antifungal, anticancer, contraceptive, anti-inflammatory, anti-coagulants, and in other cosmetics and skincare products.

Strategies to save energy in the context of the energy crisis: a review.

New technologies, systems, societal organization and policies for energy saving are urgently needed in the context of accelerated climate change, the Ukraine conflict and the past coronavirus disease 2019 pandemic. For instance, concerns about market and policy responses that could lead to new lock-ins, such as investing in liquefied natural gas infrastructure and using all available fossil fuels to compensate for Russian gas supply cuts, may hinder decarbonization efforts. Here we review energy-saving solutions with a focus on the actual energy crisis, green alternatives to fossil fuel heating, energy saving in buildings and transportation, artificial intelligence for sustainable energy, and implications for the environment and society. Green alternatives include biomass boilers and stoves, hybrid heat pumps, geothermal heating, solar thermal systems, solar photovoltaics systems into electric boilers, compressed natural gas and hydrogen. We also detail case studies in Germany which is planning a 100% renewable energy switch by 2050 and developing the storage of compressed air in China, with emphasis on technical and economic aspects. The global energy consumption in 2020 was 30.01% for the industry, 26.18% for transport, and 22.08% for residential sectors. 10-40% of energy consumption can be reduced using renewable energy sources, passive design strategies, smart grid analytics, energy-efficient building systems, and intelligent energy monitoring. Electric vehicles offer the highest cost-per-kilometer reduction of 75% and the lowest energy loss of 33%, yet battery-related issues, cost, and weight are challenging. 5-30% of energy can be saved using automated and networked vehicles. Artificial intelligence shows a huge potential in energy saving by improving weather forecasting and machine maintenance and enabling connectivity across homes, workplaces, and transportation. For instance, 18.97-42.60% of energy consumption can be reduced in buildings through deep neural networking. In the electricity sector, artificial intelligence can automate power generation, distribution, and transmission operations, balance the grid without human intervention, enable lightning-speed trading and arbitrage decisions at scale, and eliminate the need for manual adjustments by end-users.

Artificial intelligence for waste management in smart cities: a review.

The rising amount of waste generated worldwide is inducing issues of pollution, waste management, and recycling, calling for new strategies to improve the waste ecosystem, such as the use of artificial intelligence. Here, we review the application of artificial intelligence in waste-to-energy, smart bins, waste-sorting robots, waste generation models, waste monitoring and tracking, plastic pyrolysis, distinguishing fossil and modern materials, logistics, disposal, illegal dumping, resource recovery, smart cities, process efficiency, cost savings, and improving public health. Using artificial intelligence in waste logistics can reduce transportation distance by up to 36.8%, cost savings by up to 13.35%, and time savings by up to 28.22%. Artificial intelligence allows for identifying and sorting waste with an accuracy ranging from 72.8 to 99.95%. Artificial intelligence combined with chemical analysis improves waste pyrolysis, carbon emission estimation, and energy conversion. We also explain how efficiency can be increased and costs can be reduced by artificial intelligence in waste management systems for smart cities.

Microplastic sources, formation, toxicity and remediation: a review.

Microplastic pollution is becoming a major issue for human health due to the recent discovery of microplastics in most ecosystems. Here, we review the sources, formation, occurrence, toxicity and remediation methods of microplastics. We distinguish ocean-based and land-based sources of microplastics. Microplastics have been found in biological samples such as faeces, sputum, saliva, blood and placenta. Cancer, intestinal, pulmonary, cardiovascular, infectious and inflammatory diseases are induced or mediated by microplastics. Microplastic exposure during pregnancy and maternal period is also discussed. Remediation methods include coagulation, membrane bioreactors, sand filtration, adsorption, photocatalytic degradation, electrocoagulation and magnetic separation. Control strategies comprise reducing plastic usage, behavioural change, and using biodegradable plastics. Global plastic production has risen dramatically over the past 70 years to reach 359 million tonnes. China is the world's top producer, contributing 17.5% to global production, while Turkey generates the most plastic waste in the Mediterranean region, at 144 tonnes per day. Microplastics comprise 75% of marine waste, with land-based sources responsible for 80-90% of pollution, while ocean-based sources account for only 10-20%. Microplastics induce toxic effects on humans and animals, such as cytotoxicity, immune response, oxidative stress, barrier attributes, and genotoxicity, even at minimal dosages of 10 µg/mL. Ingestion of microplastics by marine animals results in alterations in gastrointestinal tract physiology, immune system depression, oxidative stress, cytotoxicity, differential gene expression, and growth inhibition. Furthermore, bioaccumulation of microplastics in the tissues of aquatic organisms can have adverse effects on the aquatic ecosystem, with potential transmission of microplastics to humans and birds. Changing individual behaviours and governmental actions, such as implementing bans, taxes, or pricing on plastic carrier bags, has significantly reduced plastic consumption to 8-85% in various countries worldwide. The microplastic minimisation approach follows an upside-down pyramid, starting with prevention, followed by reducing, reusing, recycling, recovering, and ending with disposal as the least preferable option.

Maternal and fetal outcomes after bariatric surgeries.

Introduction: Obesity is the most common medical problem affecting reproductive-age women. To detect the prevalence of obesity, and bariatric surgeries (BSs) in reproductive-age women, and the impact of obesity vs. BSs on the subsequent pregnancy outcomes. Material and methods: Obese-pregnant women, and women underwent BSs before the current pregnancy, with complete antenatal, and delivery records were included in the current study. Collected data were analyzed using MedCalc 20.106 to calculate the odd ratio (OR), and relative risk (RR) of adverse maternal, and fetal outcomes in relation to maternal obesity vs. BSs. Results: Data of 14,474 pregnant women were collected during this study; 33.94% (4912/14474) of them were obese, and 3.8% (546/14474) of them had previous BSs before the current pregnancy. The obese group has significantly higher odds, and RR of gestational diabetes mellitus (GDM) [OR 1.9 (p = 0.0001), and RR 1.79 (p = 0.0001)], gestational hypertension [OR 1.7 (p = 0.0002), and RR 1.6 (p = 0.0003)], and preeclampsia (PE) [OR 1.7 (p = 0.0001), and RR 1.6 (p = 0.0001)] compared to BSs group. The obese group has also significantly higher odds, and RR of cesarean sections (CSs) [OR 1.3 (p = 0.008), and RR 1.25 (p = 0.01)], and large for gestational age [OR 1.39 (p = 0.01), and RR 1.3 (p = 0.02)] compared to BSs group. Conclusions: About 33.94% of the reproductive-age women in Kuwait are obese, and 3.8% of them had previous BSs. Obese-pregnant women are at increased risks of GDM, gestational hypertension, PE, and CSs. Bariatric surgeries reduced the rates of GDM, gestational hypertension, PE, and CSs significantly.

Biochar for agronomy, animal farming, anaerobic digestion, composting, water treatment, soil remediation, construction, energy storage, and carbon sequestration: a review.

In the context of climate change and the circular economy, biochar has recently found many applications in various sectors as a versatile and recycled material. Here, we review application of biochar-based for carbon sink, covering agronomy, animal farming, anaerobic digestion, composting, environmental remediation, construction, and energy storage. The ultimate storage reservoirs for biochar are soils, civil infrastructure, and landfills. Biochar-based fertilisers, which combine traditional fertilisers with biochar as a nutrient carrier, are promising in agronomy. The use of biochar as a feed additive for animals shows benefits in terms of animal growth, gut microbiota, reduced enteric methane production, egg yield, and endo-toxicant mitigation. Biochar enhances anaerobic digestion operations, primarily for biogas generation and upgrading, performance and sustainability, and the mitigation of inhibitory impurities. In composts, biochar controls the release of greenhouse gases and enhances microbial activity. Co-composted biochar improves soil properties and enhances crop productivity. Pristine and engineered biochar can also be employed for water and soil remediation to remove pollutants. In construction, biochar can be added to cement or asphalt, thus conferring structural and functional advantages. Incorporating biochar in biocomposites improves insulation, electromagnetic radiation protection and moisture control. Finally, synthesising biochar-based materials for energy storage applications requires additional functionalisation.

Surgical and quality of life outcomes after pelvic organ prolapse surgery in older postmenopausal women.

INTRODUCTION: To evaluate the surgical outcome, and quality of life (QoL) 12-months after Le Fort colpocleisis (LFC), and sacrospinous fixation (SSF) in older postmenopausal women. MATERIAL AND METHODS: Eighty-six (86) post-menopausal women were included in this study (38 in the LFC group and 48 in the SSF group). Pelvic organ prolapse quantification (POP-Q) was used to evaluate the participants' pelvic organ prolapse (POP) pre-operatively and post-operatively (PO). The Arabic version of the WHOQoL-BREF Inventory was used to evaluate the participants' QoL preoperatively and post-operatively. The surgical outcome and QoL 12-months after LFC and SSF were analysed to evaluate the surgical outcome, as well as QoL 12 months after LFC and SSF. RESULTS: The pre-operative Aa, Ba, D, Ap, and Bp values of POP-Q significantly improved 12 months PO in the LFC group (p1 = 0.004, 0.0006, 0.02, 0.004, and 0.0001; respectively), and in the SSF group (p1 = 0.003, 0.0003, 0.003, 0.0005, and 0.01, respectively). Eighty (93.02%) of the studied women had no prolapse at 12-month PO follow-up. The 12-month PO psychological and social health domains were significantly higher in the SSF group compared to the LFC group (p2 = 0.04, and 0.02, respectively). In addition, the 12-month PO general health satisfaction and total QoL scores were significantly higher in the SSF group compared to the LFC group (p2 = 0.03 and 0.01, respectively). CONCLUSIONS: LFC can be considered a good surgical procedure with minimal or neglectable complications for POP in older postmenopausal women with multiple co-morbidities. The psychological and social health domains, general health satisfaction, and total QoL score were significantly higher in the SSF group compared to LFC group 12 months PO.

Routine haemoglobin assay after uncomplicated caesarean sections.

INTRODUCTION: This study designed to detect whether the routine haemoglobin (Hb) assay after uncomplicated caesarean section (CS) is necessary. MATERIAL AND METHODS: One hundred and twenty-two (122) women who delivered by uncomplicated elective CS were included in this observational study. Pre-operative investigations were performed according to the hospital protocol, including complete blood count, haemoglobin, prothrombin time, activated partial thromboplastin time, and liver and kidney function tests. After the uncomplicated elective CS, blood samples taken from participants immediately, 12, 24, 48 hours, and 1-week post-operative (PO) for haemoglobin assay. Student's t-test was used to compare the pre-operative, and PO haemoglobins to detect whether or not the Hb assay after uncomplicated CSs is necessary. RESULTS: There was no significant difference between the pre-operative haemoglobin (11.6 ± 6.4 gms%), and the immediate PO haemoglobin (11.1 ± 5.9; p = 0.1 [95% CI: -1.05, 0.5, 2.05]) or 12-hour PO haemoglobin (10.9 ± 7.3; p = 0.9 [95% CI: -1.03, 0.7, 2.43]) or 24-hour PO haemoglobin (10.7 ± 8.2; p = 0.9 [95% CI: -0.95, 0.9, 2.75]). In addition, there was no significant difference between the pre-operative haemoglobin (11.6 ± 6.4 gms%), and 48-hour PO haemoglobin (11.2 ± 6.9; p = 0.7 [95% CI: -1.28, 0.4, 2.08]), or 1-week PO haemoglobin (11.4 ± 7.5; p = 0.9 [95% CI: -1.55, 0.2, 1.95]). CONCLUSIONS: Routine PO haemoglobin assay after uncomplicated elective CSs is not necessary, especially when the pre-operative haemoglobin before the ECS ≥ 11 gms%, CS duration < 45 min, and estimated intra-operative blood loss ≤ 500 mL.

Relation between chronic endometritis and recurrent miscarriage.

INTRODUCTION: Growing interest has focused on the relation between chronic endometritis (CE) or asymptomatic inflammation of the endometrium and recurrent miscarriage (RM).The aim of the study was to assess the relation between CE and RM and the accuracy of hysteroscopy in diagnosing CE. MATERIAL AND METHODS: One hundred and ten (110) women with unexplained RM were included in this study. Participants were subjected to diagnostic hysteroscopy for uterine cavity, and endometrium evaluation. The diagnosis of CE during hysteroscopic examination was based on CE-related hysteroscopic signs (micro-polyps, stromal edema, and/or hyperemia). At the end of hysteroscopy, an endometrial biopsy was taken from participants for culture, and immunohistochemical (IHC) staining. Collected data were analyzed to assess the relation between CE and RM and the accuracy of hysteroscopy in diagnosing CE. RESULTS: The prevalence of CE in women with RM was 31.8% using CE-related hysteroscopic signs, while it was 38.2% using IHC staining and endometrial cultures (p = 0.4). CE-related hysteroscopic signs had 64.1% sensitivity, 85.9% specificity, 71.4% positive predictive value (PPV), 81.3% negative predictive value (NPV), and 78.2% overall accuracy in diagnosing CE. Most cases of CE (> 81%) were caused by Mycoplasma and common pathogens. CONCLUSIONS: The prevalence of CE in women with RM was 31.8% using CE-related hysteroscopic signs, while it was 38.2% using IHC staining and endometrial cultures. CE-related hysteroscopic signs had 64.1% sensitivity, 85.9% specificity, 71.4% PPV, 81.3% NPV, and 78.2% overall accuracy in diagnosing CE. Most cases of CE (> 81%) were caused by Mycoplasma and common pathogens.

Common endocrine disorders associated with the polycystic ovary syndrome.

INTRODUCTION: Screening of polycystic ovary syndrome (PCOS) women for hypothyroidism and hyperprolactinemia was suggested, because the undiagnosed hypothyroidism and hyperprolactinemia can aggravate the PCOS symptoms. AIM OF THE STUDY: To determine whether the insulin resistance (IR), hypothyroidism, and hyperprolactinemia are common endocrine disorders associated with the PCOS. MATERIAL AND METHODS: One hundred and twenty PCOS women were compared to 120 non-PCOS controls in this study. Participants' day 2-3 hormonal profile and insulin resistance (IR) using the fasting glucose and fasting insulin were evaluated. Collected data were analyzed to determine whether the IR, hypothyroidism, and hyperprolactinemia are common endocrine disorders associated with the PCOS. RESULTS: TSH and prolactin were significantly high in PCOS women (6.4 ±4.2 and 934 ±102.3, respectively) than controls (3.5 ±3.3 and 445 ±77.5 mIU/ml, respectively) (p = 0.004 and 0.001, respectively). The PCOS women had significantly high relative risk of IR (RR 3.0 (95% CI: 1.9-4.7) p < 0.0001), hypothyroidism (RR 3.4; 95% CI: 1.7-6.9) (p = 0.0005), and hyperprolactinaemia (RR 3.15; 95% CI: 1.8-5.6) (p = 0.0001) than controls. The PCOS women had higher odds of IR (OR 4.8; 95% CI: 2.6-8.8) (p < 0.0001), hypothyroidism (OR 4.29; 95% CI: 1.9-9.4) (p = 0.0003), and hyperprolactinaemia (OR 4.27; 95% CI: 2.1-8.5) (p < 0.0001) than controls. CONCLUSIONS: TSH and prolactin were significantly high in studied PCOS women, and 47.5% of the studied PCOS women had IR. The PCOS women had significantly higher odds and relative risks of IR, hypothyroidism, and hyperprolactinemia than controls. IR, hypothyroidism, and hyperprolactinemia are common endocrine disorders associated with PCOS.

Impacts of iron oxide and titanium dioxide nanoparticles on biogas production: Hydrogen sulfide mitigation, process stability, and prospective challenges.

Anaerobic digestion for biogas production is one of the most used technology for bioenergy. However, the adoption of nanoparticles still needs further studies. Therefore, this study was designed to examine the effect of metal oxide nanoparticles (MONPs) at four different concentrations in two different combinations, 20 (R1) and 100 (R2) mg/L for Fe2O3, 100 (R3) and 500 (R4) mg/L for TiO2, and a mixture of Fe2O3 and TiO2 at rates of 20, 500 (R5) and 100, and 500 (R6), on hydrogen sulfide (H2S) mitigation, biogas, and methane (CH4) yield during the anaerobic digestion of cattle manure (CM) using an anaerobic batch system. The results showed that H2S production was 2.13, 2.38, 2.37, 2.51, 2.64, and 2.17 times lower than that of the control (R0), respectively, when the CM was treated by the aforementioned MONPs. Additionally, biogas and CH4 production were 1.09 and 1.105, 1.15 and 1.191, 1.07 and 1.097, 1.17 and 1.213, 1.10 and 1.133, and 1.13 and 1.15 times higher than those of R0 when R1, R2, R3, R4, R5, and R6 were supplemented with MONPs, respectively. The highest specific production of biogas and CH4 was 336.25 and 192.31 mL/gVS, respectively, which was achieved by R4 supplemented with 500 mg/L TiO2 NPs, while the corresponding values in the case of R0 were 286.38 and 158.55 mL/gVS.

Ovarian function and ovarian blood supply following premenopausal abdominal hysterectomy.

INTRODUCTION: The issue of conserving the ovaries at hysterectomy in premenopausal women with benign gynecologic disease has been the subject of considerable controversy. Some clinicians prefer prophylactic oophorectomy in premenopausal women during hysterectomy to prevent future development of malignant changes in conserved ovaries. Other clinicians prefer to conserve apparently normal ovaries, because bilateral oophorectomy in premenopausal women results in an abrupt imbalance, sudden onset of menopausal symptoms, decreased libido, increased cardiovascular risk and osteoporosis. MATERIAL AND METHODS: Two hundred and twenty multipara women (who had completed their families), with benign uterine pathology were included in this prospective study for abdominal hysterectomy with bilateral ovarian preservation. Pre-operative vaginal ultrasound, Doppler studies, diagnostic hysteroscopy and endometrial biopsy were done followed by laboratory studies including Anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol for all studied women. Doppler studies, AMH, FSH and estradiol were repeated 6 and 12 months post-operative for assessment of the ovarian function and ovarian blood supply after hysterectomy. RESULTS: Pre-operative AMH, FSH and estradiol of the studied women were statistically insignificant compared to AMH, FSH and estradiol 6 and 12 months post-operative. Twelve months post-operative right and left ovarian volumes (6.92 ± 0.18 and 6.85 ± 0.19 cm(3), respectively) were significantly larger than pre-operative right and left ovarian volumes (6.19 ± 0.22 and 5.86 ± 0.23 cm(3), respectively), and, 12 months post-operative right and left ovarian pulsatility indices (2.92 ± 0.15 and 2.96 ± 0.16 cm/s, respectively) were significantly lower than pre-operative right and left ovarian pulsatility indices (3.45 ± 0.19 and 3.36 ± 0.2 cm/s, respectively). Eight (3.6%) cases of the studied women developed an ovarian cyst 6 months after hysterectomy, 3 were spontaneously resolved and the remaining 5 (2.27%) cases underwent exploratory laparotomy. CONCLUSIONS: There is no evidence of ovarian dysfunction affecting conserved ovaries one year after hysterectomy in premenopausal women as evident by AMH, FSH and estradiol. Furthermore, an increased ovarian volume and reduced ovarian pulsatility indices indicate a possible increase in ovarian blood supply, and preserved non-compromised ovarian function.

Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse.

AIM OF THE STUDY: Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. MATERIAL AND METHODS: Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound. Surgically removed uteri and ovaries were sent for histopathological examination. Results of histopathological examination as gold standard were compared with conventional gynecological screening methods. RESULTS: Histopathological examination of surgically removed uteri and ovaries after vaginal hysterectomy for uterovaginal prolapse showed abnormal findings in 61.25% (49/80) of studied cases (10 chronic cervicitis; 20 cervical intra-epithelial neoplasia-1 [CIN-1]; 5 CIN-2; 2 CIN-3; 10 simple endometrial hyperplasia without atypia and 2 simple serous ovarian cyst). Also, histopathological examination showed premalignant changes in 33.75% (27/80) of studied cases (20 CIN-1; 5 CIN-2 and 2 CIN-3), which mean 50% sensitivity of pre-operative Pap smear to detect premalignant cervical changes. CONCLUSIONS: Asymptomatic women with utero-vaginal prolapse may have associated premalignant lesions which may not be detected by conventional screening methods, and this should be explained preoperatively for women undergoing surgery, especially if conservative management was considered.

Role of hysteroscopy and endometrial biopsy in women with unexplained infertility.

OBJECTIVES: This study was designed to evaluate the role of hysteroscopy and endometrial biopsy in women with unexplained infertility. PATIENTS AND METHODS: Women with unexplained infertility were included in this prospective study, evaluated with transvaginal sonography and diagnostic hysteroscopy. Diagnostic hysteroscopy was performed between the 7th and 11th day of the cycle. The criteria for hysteroscopic findings were based on the cervical canal, uterine cavity, endometrium, visualization of the ostium tubae and lesions of the utero-tubal junction. After the hysteroscopic examination, endometrial biopsy was performed using a Pipelle endometrial suction curette. Patients were classified according to the hysteroscopy results into four groups: patients with no abnormality detected (14), patients with cervical abnormalities (six), patients with endometrial abnormalities (73) and patients with uterine abnormalities (seven). RESULTS: One hundred women with unexplained infertility were included. All patients underwent diagnostic hysteroscopy, except for seven patients: six patients had stenotic external or internal cervical ostium and one had inadequate visualization as the uterine cavity was filled with blood. Based on hysteroscopic findings, 31 patients were finally diagnosed with endometrial polyps; 14 endometritis; 15 endometrial hyperplasia; six submucous myomas; seven intrauterine synechiae (73 cases = endometrial abnormalities group); seven congenital uterine anomalies (uterine abnormalities group), six cervical stenosis (cervical abnormalities group) and 14 women without any uterine abnormalities (no abnormalities group). Analysis of samples obtained using the Pipelle endometrial suction curette was non-diagnostic in 16 cases; the most common endometrial pathological feature detected by this analysis was endometritis (15%). CONCLUSIONS: Routine hysteroscopy and endometrial biopsy should be used as a basic part of the work-up for women with unexplained infertility.

Municipal solid waste management challenges in developing regions: A comprehensive review and future perspectives for Asia and Africa.

The rapid urbanization witnessed in developing countries in Asia and Africa has led to a substantial increase in municipal solid waste (MSW) generation. However, the corresponding disposal strategies, along with constraints in land resources and finances, compounded by unorganized public behaviour, have resulted in ineffective policy implementation and monitoring. This lack of systematic and targeted orientation, combined with blind mapping, has led to inefficient development in many areas. This review examines the key challenges of MSW management in developing countries in Asia and Africa from 2013 to 2023, drawing insights from 170 academic papers. Rather than solely focusing on recycling, the study proposes waste sorting at the source, optimization of landfill practices, thermal treatment measures, and strategies to capitalize on the value of waste as more pertinent solutions aligned with local realities. Barriers to optimizing management systems arise from socio-economic factors, infrastructural limitations, and cultural considerations. The review emphasizes the importance of integrating the study area into the circular economy framework, with a focus on enhancing citizen participation in solid waste reduction and promoting recycling initiatives, along with seeking economic assistance from international organizations.

Synthesis of eco-friendly layered double hydroxide and nanoemulsion for jasmine and peppermint oils and their larvicidal activities against Culex pipiens Linnaeus.

Mosquito-borne diseases represent a growing health challenge over time. Numerous potential phytochemicals are target-specific, biodegradable, and eco-friendly. The larvicidal activity of essential oils, a jasmine blend consisting of Jasmine oil and Azores jasmine (AJ) (Jasminum sambac and Jasminum azoricum) and peppermint (PP) Mentha arvensis and their nanoformulations against 2nd and 4th instar larvae of Culex pipiens, was evaluated after subjecting to different concentrations (62.5, 125, 250, 500, 1000, and 2000 ppm). Two forms of phase-different nanodelivery systems of layered double hydroxide LDH and oil/water nanoemulsions were formulated. The synthesized nanoemulsions showed particle sizes of 199 and 333 nm for AJ-NE and PP-NE, with a polydispersity index of 0.249 and 0.198, respectively. Chemical and physiochemical analysis of TEM, SEM, XRD, zeta potential, drug loading capacity, and drug release measurements were done to confirm the synthesis and loading efficiencies of essential oils' active ingredients. At high concentrations of AJ and PP nanoemulsions (2000 ppm), O/W nanoemulsions showed higher larval mortality than both LDH conjugates and crude oils. The mortality rate reached 100% for 2nd and 4th instar larvae. The relative toxicities revealed that PP nanoemulsion (MA-NE) was the most effective larvicide, followed by AJ nanoemulsion (AJ-NE). There was a significant increase in defensive enzymes, phenoloxidase, and α and ß-esterase enzymes in the treated groups. After treatment of L4 with AJ, AJ-NE, PP, and PP-NE, the levels of phenoloxidase were 545.67, 731.00, 700.00, and 799.67 u/mg, respectively, compared with control 669.67 u/mg. The activity levels of α-esterase were 9.71, 10.32, 8.91, and 10.55 mg α-naphthol/min/mg protein, respectively. It could be concluded that the AJ-NE and PP-NE nanoformulations have promising larvicidal activity and could act as safe and effective alternatives to chemical insecticides.

Epidural anaesthesia and myomectomy-associated blood loss - a prospective randomised controlled study.

OBJECTIVES: The management of anaesthesia for patients with large myomas is particularly important due to disruption of hemodynamic as a result of massive haemorrhage, the prolonged duration of surgery and requirement for additional interventions. This study evaluated the effect of anaesthetic technique on blood loss in patients undergoing myomectomy due to large fibroid uterus. MATERIAL AND METHODS: A total of 156 patients that underwent myomectomy were randomized into two equal groups according to the type of anaesthesia: Epidural anaesthesia group and General anaesthesia group. The volume of blood loss and blood products transfusion was reviewed for each patient. RESULTS: The intraoperative blood loss and need for blood transfusion were significantly higher in general anaesthesia group (p < 0.001). The mean hematocrit change was 2.5 ± 1.5 vs 3.7 ± 2.9 % (p = 0.001) for both groups. CONCLUSIONS: In the myomectomy planning of women with a large fibroid uterus, the team of gynecologists and anaesthesiologists should take care to choose the most optimal technique for anaesthesia.

Impact of foliar spray of zinc oxide nanoparticles on the photosynthesis of Pisum sativum L. under salt stress.

This study investigates the impacts of zinc oxide nanoparticles: bare (ZnO NPs) and ZnO NPs coated with silicon shell (ZnO-Si NPs), on Pisum sativum L. under physiological and salt stress conditions. The experimental results revealed that the foliar spray with ZnO-Si NPs and 200 mg/L ZnO NPs did not influence the stomata structure, the membrane integrity, and the functions of both photosystems under physiological conditions, while 400 mg/L ZnO-Si NPs had beneficial effects on the effective quantum yield of photosystem II (PSII) and the photochemistry of photosystem I (PSI). On the contrary, small phytotoxic effects were registered after spraying with 400 mg/L ZnO NPs accompanied by stimulation of the cyclic electron flow around PSI and an increase of the non-photochemical quenching (NPQ). The results also showed that both types of NPs (with exception of 400 mg/L ZnO NPs) decrease the negative effects of 100 mM NaCl on the photochemistry of PSI (P700 photooxidation) and PSII (qp, Fv/Fm, Fv/Fo, ΦPSII, Φexc), as well as on the pigment content, stomata closure and membrane integrity. The protective effect was stronger after spraying with ZnO-Si NPs in comparison to ZnO NPs, which could be due to the presence of Si coating shell. The role of Si shell is discussed.

Complications associated with higher order compared to lower order cesarean sections.

Background: The rate of multiple cesarean sections is persistently on the rise because of cultural demands for large families, and multiple cesarean sections are an important cause of maternal morbidity and mortality.Objectives: This study was designed to detect the complications associated with higher order compared to lower order cesarean sections.Materials and methods: The hospitals record of women who had a cesarean section performed after three or more previous cesarean sections, and those who had a cesarean section for the second time over 2 years reviewed. Women with ≥3 cesarean sections admitted for elective cesarean section after 38 weeks' gestation, and those with ≥3 cesarean sections admitted in labor for emergency cesarean section were included in group 1. Women with history of previous one lower segment cesarean section (LSCS), who refused trial of labor and women with one LSCS who had an emergency cesarean section after failed trial of labor (TOL) were included in group 2. Antenatal, intraoperative, and postoperative data were reviewed. Statistical analysis done using SPSS version 20 (Chicago, Illinois, USA), to detect the complications associated with higher order compared to lower order cesarean sections. Primary outcome measures; complications associated with higher order compared to lower order cesarean sections. Secondary outcome measures; intraoperative, and postoperative complications.Results: Four hundred and fifty (450) women undergoing repeat cesarean section studied; 32.2% (145/450) had ≥3 previous cesarean sections (group 1), and 67.8% (305/450) had previous one cesarean section (group 2). In group 1, 77.2% (112/145) had previous three cesarean sections, 12.4% (18/145) had previous four cesarean sections, 9% (13/145) had previous five cesarean sections, and 1.4% (2/145) had previous six cesarean sections. The proportion of unbooked admission, and emergency cesarean sections were significantly high in group 2 compared to group 1 (11.1% (34/305) and 73.1% (223/305) versus 4.83% (7/145) and 40.7% (59/145); respectively) (p<.05, 95% CI; 0.1-0.2) and p<.01, 95% CI; 0.4-11.4; respectively. The risk of dense omental adhesions, and bladder injuries were significantly high in group 1 compared to group 2 (4.14% (6/145) and 1.38% (2/145) versus 0.66% (2/305) and 0% (0/305); respectively), (p=.01 (95% CI; 0.6-1.6) and p=.01 (95% CI; 0.5-5.5); respectively). Logistic regression analysis showed that the bladder injury was 5 times more (odds ratio 5.0 (95% CI; 0.035-711.8)) and the blood transfusion was 4.7 times more (odds ratio 4.7 (95% CI; 0.147-151.5)) in women with >3 repeat cesarean sections compared to women with previous one cesarean section (insignificant difference p=.52 and .38; respectively).Conclusion: The risk of dense omental adhesions and bladder injury was significantly high in women with previous ≥3 cesarean sections compared to women with previous one cesarean section. Logistic regression analysis showed that the bladder injury was five times more and the blood transfusion was 4.7 times more in women with >3 repeat cesarean sections compared to women with previous one cesarean section (insignificant difference).