The aim of this study was to evaluate the role of platelet count (PLT) and platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) as a clinical biomarker in 64 infertile males with varicocele and 45 controls. In addition, semen parameters, serum total testosterone, FSH and testicular volume were measured before and at 6 months after varicocelectomy. The mean PLT, MPV, PDW and PCT were 231 ± 42 × 103/µl, 9.6 ± 1.8 fl, 16.2 ± 2.5 fl and 0.18% in the patient group respectively. When the patient and control groups were compared, there was a significant increase in mean MPV, PDW and PCT (p < .0001), while platelet count was lower in patients than control group, but with no significant relationship. MPV had a significant negative correlation with total testosterone (p < .03). No significant correlations were found between PVI and testicular volume. After follow-up of 37.1 ± 1.9 months, a significant negative correlation was found between the preoperative MPV and varicocelectomy outcome in terms of semen values (p < .007). So, the increase in MPV and low total testosterone in men with varicocele may be a feature of high risk of infertility. K E Y W O R D Sinfertility, mean platelet volume, platelets count, semen parameters, varicocele 2 of 5 | GHANEM Et Al. | MATERIAL S AND ME THODS | Study sampleA total of 180 clinically diagnosed varicocele cases referred to our urology department with infertility. From this group, 64 patients with abnormal semen values underwent varicocelectomy. Forty-five infertile varicocele cases with normal semen values were randomly selected, included as control group, with a similar age between two groups. The protocol of this study followed the guidelines of the Declaration of Helsinki. Also, all the participants provided us a consent. | Selection criteriaPatient was initially included with the complaints of infertility and abnormal semen values by using WHO criteria (2010). Patients were included after excluding other genital diseases, exposure to gonadotoxins, sperm antibodies, endocrinological and internal diseases. In addition, patients with vascular problems (e.g., peripheral vascular disease, heart disease, thrombocytopenic purpura, thrombocytopenia, leukaemia and splenectomy) were excluded.The varicocele diagnosis was assigned by using the 1993 WHO guidelines. Patients with grade 1 varicocele were excluded from the study. The testicular volume was calculated by colour Doppler ultrasonography using Schiff formula (Schiff, Li, & Goldstein, 2004). | Laboratory analysisPeripheral venous samples were drawn into blood tubes containing ethylenediaminetetraacetic acid, early morning following an overnight fast, before varicocelectomy. All samples were analysed within 2 hr (Lance, Oerle, Henskens, & Marcus, 2010). The PLT and PVI (MPV, PDW and PCT) were measured using an automated blood cell analyser. Also, serum FSH, total testosterone levels and semen analysis were evaluated by using the procedure described by Mitchell et al. ...
ObjectiveThis study aimed to evaluate the predictive value of platelet volume indices (PVI), such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), as prognostic indicators of testicular viability in torsion patients with steady-state sickle cell anemia (SCA) who underwent surgical exploration.MethodsForty-eight patients with SCA with testicular torsion and 46 male control subjects were enrolled in the study. All patients underwent scrotal color Doppler ultrasonography before surgery, and PVI (MPV, PDW, and PCT) values were measured in all participants. Symptom duration and testicular volume were also recorded.ResultsThe testicular salvage rate in patients with SCA was 73% after surgery. Analyses showed that MPV, PDW, and PCT values were significantly higher in torsed SCA as compared with controls (p<0.05). Orchiectomy in patients with SCA showed significantly higher MPV, PDW, and PCT values than the orchiopexy group (p<0.05). The MPV values of orchiectomy patients showed a higher significant cut-off of ≥11.5 fL, which is higher than in torsed patients without SCA, as an indicator of testis survival. PDW also demonstrated a higher significant cut-off of ≥12.7 fL for detorsion outcomes in patients with SCA. Symptom duration of less than 7 hours was also significantly correlated with orchiopexy (p≤0.001). Univariate analysis showed that higher MPV, increased PDW, and symptom duration were indicative of the outcome of testicular detorsion in SCA. Multivariable analysis showed that increased PDW and symptom duration are prognostic parameters for testicular viability in SCA.ConclusionIncreased PDW and symptom duration can be used as parameters for predicting testicular detorsion outcomes in patients with steady-state SCA.
Metastatic renal cell carcinoma is potentially a lethal disease with in some cases aggressive behavior. The given fact that the patterns of metastases from RCC are not clearly identified, which may involve some rare metastatic locations. We present a case of 58 years old male presented with painless left scrotal mass, which was discovered to be an intrascrotal metastases appeared 3 years after nephrectomy for ipsilateral renal cell carcinoma. We believe that the rarity of the metastatic site and the intriguing possible mechanism of spread make an interesting case for clinicians and could add more follow-up measures for patients treated from renal cell carcinoma.
This study estimated the prevalence of burnout and its determinants among medical students at Jazan University during the COVID-19 pandemic. A total of 444 medical students completed an online survey containing the Maslach burnout inventory. The prevalence of burnout was 54.5%. Burnout reached its peak during the fourth year whereas it was the lowest in the internship year. Being a resident in mountain areas, being delayed in college-level, being divorced, and having divorced parents were all associated with an increased risk of burnout. During their time at medical school, students generally showed a trend of consistently high scores in the personal accomplishment subscale, a decreasing trend in the emotional exhaustion subscale, and an increasing trend in the depersonalization subscale. The most important predictive factor was having separated parents. Perceived study satisfaction appeared to be a significant protective factor in a dose–response manner. These findings suggest that burnout among medical students during the COVID-19 pandemic is a concern that should be monitored and prevented.
Introduction: There is emerging literature on the decline in adherence to preventive measures against the COVID-19 pandemic, a phenomenon of pandemic fatigue (PF). However, academics and policymakers have debated its existence and consequences. We conducted this study to explore this phenomenon, its existence, determinants, and relation to adherence to COVID-19 preventive measures, and the mediating role of resilience, fear of COVID-19, and electronic health literacy about COVID-19 in this relationship.Methods: This cross-sectional online study was conducted from April to June 2021 using a convenience sample of 650 Saudi adults from all regions of Saudi Arabia using a reliable questionnaire. A structural equation model (SEM) was used for mediation analysis.Results: The results revealed a moderate level of PF among Saudi adults. Younger patients experienced more PF. Fear of COVID-19 had a non-significant (p=0.127) effect on PF. SEM analysis revealed that both resilience and electronic health literacy significantly (p=0.000) mediated the relationship between PF and adherence to preventive measures, and acted as protective factors. In conclusion, there is evidence that PF exists and negatively affects adherence to preventive measures. Conclusion:Policymakers should apply evidence-based programs to increase public resilience, particularly targeting young adults, as the results of the current study shed light on its protective mediating role against PF. Increasing electronic health literacy is an effective strategy for preventing PF through an increase in the perceived effectiveness of preventive measures.
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