AIMTo assess the changes in semen parameters in men with spinal cord injury (SCI) and the possible causes of these changes.

METHODSThe study included 45 subjects with SCI. Semen retrieval was done by masturbation (2), vigorous prostatic massage (n = 13), penile vibratory stimulation (n = 13) or electroejaculation (n = 17).

RESULTSThe semen of men with SCI showed normal volume (2.3 +/- 1.9 mL) and sperm count (85.0 X 10(6) +/- 83.8 X 10(6)/mL) with decreased motility (11.6% +/- 0.1%), vitality (18.5% +/- 5.2%) and normal forms (17.5% +/- 3.4%), and pus cells has been increased (6.0 X 10(6) +/- 8.2 X 10(6)/mL). Total (13.4 +/- 9.9 vs. 7.1 +/- 6.8) and progressive (4.4 +/- 3.9 vs.2.2 +/- 2.1) motility were significantly higher in subjects with lower scrotal temperatures. There was no statistical significant difference between electroejaculation and penile vibratory stimulation groups as regards any of the semen parameters. Subjects'age, infrequent ejaculation, injury duration and hormonal profile showed no significant effect on semen parameters.

CONCLUSIONThe defining characteristics of the seminogram in men with SCI are normal volume and count with decreased sperm motility, vitality and normal forms, and the increased number of pus cells. The most acceptable cause of the deterioration of semen is elevated scrotal temperature.

Disease Progression ; Ejaculation ; Hormones ; blood ; Humans ; Male ; Massage ; Masturbation ; Movement ; Prostate ; physiopathology ; Semen ; physiology ; Sperm Count ; Sperm Motility ; Spinal Cord Injuries ; physiopathology ; rehabilitation ; Vibration

INTRODUCTIONLaparoscopic simple closure (LSC) coupled with Helicobacter pylori eradication is a well-recognised treatment for perforated duodenal ulcers. This study aimed to evaluate its safety and efficacy.

METHODSThis was a retrospective cohort study conducted on patients who underwent LSC of perforated duodenal ulcers from January 2002 to December 2009. Patients were stratified according to the American Society of Anesthesiologist classification and Boey's risk score.

RESULTSOf the 213 patients, 22 (10.3%) were excluded as they required conversion to open surgery. 191 (89.7%) patients who underwent successful laparoscopic repair were included in the study. The median age of the patients was 39 (range 19-73) years, and the majority were male (n = 180, 94%). Median duration of pre-hospital symptoms was eight hours and median time from admission to surgery was six hours. Median operative time was 65 minutes and median hospital stay was five days. Ten patients (median age 53.5 years) required intensive care unit admission. Two patients developed leakage from the suture line - one required re-exploration and the other was managed conservatively. Four patients had intra-abdominal abscesses - one required re-exploration, while three were managed by percutaneous radiological drainage. One patient developed pneumonia and one had pulmonary embolism. There were no surgical site infections. All patients were followed up as surgical outpatients (median duration 36 days). None of the patients required definitive surgery. There was one death in the cohort.

CONCLUSIONLSC of perforated duodenal ulcers is a reliable, safe and minimally invasive procedure that has low morbidity.

Adult ; Aged ; Duodenal Ulcer ; diagnosis ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Peptic Ulcer Perforation ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult

Purpose: We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output. Methods: Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish. Results: A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341–8.307), age (OR, 1.087; 95% CI, 1.019–1.159), academic standing (OR, 1.730; 95% CI, 1.103–2.715), and confidence (OR, 1.086; 95% CI, 1.009–1.169) were positive predictors of publication in peer reviewed journals. Conclusion The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.

Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

Case-based surveillance measles data was defined according to World Health Organization (WHO) guidelines. A total of 511 measles cases were studied from 2011 to 2015 in Southern Darfur State, Sudan and 58.1% of cases were confirmed from Nyala city. About 43.4% of cases were males, 56.6% of cases were female, and 47.7% were children under five years old. Similarity, within February to June, the cases increased by 8.0% in children vaccinated through measles campaign, and 5.3% in children that used child vaccination card and 78.7% in unvaccinated one. The epidemiologically linked (EPI-Linked) measles cases declined from 2011 to 2015; consequently, Measles still remain to be a significant challenge in south Darfur state, Sudan.