1.A Short Term Follow Up Comparison of Genu Varum Corrective Surgery Using Open and Closed Wedge High Tibial Osteotomy
Ali Tabrizi ; Jafar soleimanpour ; Ali Sadighi ; Ali Jafari Zare
Malaysian Orthopaedic Journal 2013;7(1):7-12
Introduction: Knee deformity associated with osteoarthritis
(OA) is one of the most common complications seen in
patients referred to orthopaedic surgeons. High tibial
osteotomy (HTO) is an accepted method for treatment of
medial knee osteoarthritis with varus deformity. The aim of
this study was to compare results of osteotomy methods in
patients with genu varum (GV) deformity. Methods: In this
cohort study, the sample consisted of 32 patients with genu
varum deformity (42 knees) who were divided into two
groups and matched according to age and gender. The
patients were treated with open or closed wedge osteotomy.
After surgery, they were followed-up and compared for 6
months. Results: The sample consisted of 25 women
(87.2%) and 7 men (21.8%). Ten patients (31.2%) presented
with bilateral deformity. The incidence of complications was the same for both procedures (12.5%); this included one
peroneal nerve injury following closed wedge surgery.
Overall, patient satisfaction was 87.5% and 75% for the open and closed wedge methods respectively. Operative time,
days to full weight bearing, and days to return to routine
activities were significantly shorter for patients treated with the open wedge method (p<0.001). Conclusion: Open
wedged HTO is associated with shorter operating time,
shorter recovery time, higher patient satisfaction, and
probable lower risk of neurological injury.
2.Bridging the Gap between AZF Microdeletions and Karyotype: Twelve Years’ Experience of an Infertility Center
Hamid KALANTARI ; Marjan SABBAGHIAN ; Paraskevi VOGIATZI ; Amarnath RAMBHATLA ; Ashok AGARWAL ; Giovanni M. COLPI ; Mohammad Ali Sadighi GILANI
The World Journal of Men's Health 2023;41(3):659-670
Purpose:
Despite all past efforts, the current guidelines are not explicit enough regarding the indications for performing azoospermia factor (AZF) screening and karyotype, burdening clinicians with the decision to assess whether such tests are meaningful for the infertile male patient. These assessments can be costly and it is up to the healthcare practitioner to decide which are necessary and to weigh the benefits against economic/psychological harm. The aim of this study is to address such gaps and provide update on current management options for this group of patients.
Materials and Methods:
To address such gaps in male infertility management and to elucidate whether AZF screening is indicated in individuals who concomitantly harbor chromosomal abnormalities we conducted a retrospective cohort analysis of 10,388 consecutive patients with non-obstructive azoospermia (NOA) and severe oligozoospermia.
Results:
Previously, it has been suggested that all NOA cases with chromosomal defects, except males with 46,XY/45,X karyotype, have no indication for AZF screening. Our findings revealed that cases carrying the following chromosomal abnormalities inv(Y)(p11.2q12); idic(Y)(q11.2); 46,XY,r(Y); idic(Y)(p11.2) and der(Y;Autosome) (76/169; 44.9%; 95% CI, 37.7–52.5) should also be referred for AZF deletion screening. Here, we also report the correlation between sperm count and AZF deletions as a secondary outcome. In accordance with previously reported data from North America and Europe, our data revealed that only 1% of cases with >1×106 sperm/mL had Y chromosome microdeletions (YCMs).
Conclusions
In the era of assisted reproduction, finding cost-minimization strategies in infertility clinics without affecting the quality of diagnosis is becoming one of the top prioritized topics for future research. From a diagnostic viewpoint, the results reflect a need to reconsider the different karyotype presentations and the sperm count thresholds in male infertility guidelines as indicators for YCM screening during an infertility evaluation.