Diagnostic hysteroscopy should be used routinely in the work-up of infertile woman, even in the presence of eumenorrhea. Persistent functional endometrial polyps, even if small, are likely to impair fertility in this select patient group. Removal of such lesions may improve subsequent reproductive performance.

In thoracic surgery with OLV, the use of epidural dexmedetomidine decreases the anaesthetic requirements significantly, prevents awareness during anaesthesia and improves intraoperative oxygenation and post-operative analgesia.

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Direct oral anticoagulant (DOAC) agents are becoming the anticoagulation strategy of choice. However, their use in the treatment of acute venous thromboembolism (VTE) in morbidly obese patients (bodyweight of > 120 kg or BMI > 40 kg/ m 2) guarded. This is due to the scarce data supporting their use in this population. As a result, the International Society on Thrombosis and Haemostasis recommended against their use in this cohort of patients. New data emerged supporting the use of DOACs in these patients. Hence, we aimed to systematically review the literature exploring the efficacy and safety of these agents compared to warfarin in VTE treatment in morbidly obese patients. A systematic review of PubMed and EMBASE since inception until 01/04/2020. Subsequently, a non-inferiority (NI of 1.75) meta-analysis utilizing the random-effects model. Five observational studies (6585 patients) were included in our meta-analysis. DOAC analogs were non-inferior compared to warfarin in reducing the primary efficacy outcome of VTE recurrence (OR 1.07, 95% CI 0.93-1.23) and the primary safety outcome (major bleeding events) (OR 0.80, 95% CI 0.54-1.17). Our meta-analysis comprising real-world observational data concludes that the use of DOAC analogs in morbidly obese patients (bodyweight of > 120 kg or BMI > 40 kg/m 2) is non-inferior with regards to efficacy and safety compared to warfarin. This finding helps to resolve the uncertainty associated with the use of DOACs in this cohort. Additionally, it invites for a confirmatory non-inferiority randomized controlled trial testing DOAC vs. Warfarin in this group of patients.

LLR is superior to the OLR with significantly shorter duration of hospital stay and does not compromise the oncological outcomes.

Heavy metal pollution has become one of the most serious environmental problems today. Biological methods such as biosorption or bioaccumulation strategies for the removal of metals ions may provide an attractive alternative to existing technologies. Microorganisms, as heavy metal bioadsorbents, offer a new alternative for removal of toxic or valuable metals in water. Saccharomyces cerevisiae has received increasing attention due to its unique nature and capacity for metal sorption. It is one of the most promising biosorbents capable of removing metal ions from aqueous solution. Manganese occurs naturally in many surface water and groundwater sources and in soils that may erode into this water. Eleven S. cerevisiae yeast strains in alive and dead forms were screened for biosorption and bioaccumulation of manganese from artificial aqueous solution. S. cerevisiae F-25 in alive form was found to be highly biosorbent for Mn +2 and biosorbed 22.5 mg Mn +2 /gm yeast biomass. Optimization of environmental conditions reveals that optimum concentrations for maximum Mn 2+ biosorption by S. cerevisiae F-25 in alive form were 4.8 mg Mn 2+ /l after 30 min at pH 7, agitation 150 rpm and yeast biomass concentration 0.1 gm/l at 30°C. Competition of Mn +2 with other heavy metals shows that Mn +2 in control sample without, any other heavy metals added in solution at 4.8 mg/l of the biosorbed Mn +2 was 41.3 mg/g biomass. Addition of other heavy metals affects the percent of biosorbed Mn +2 . ª 2015 Production and hosting by Elsevier B.V. on behalf of Housing and Building National Research Center. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

PTGBD and ELC are highly efficient in resolving cholecystitis sepsis. Delayed cholecystectomy after PTGBD produces better outcomes with a lower conversion rate, fewer procedure-related complications, and a shorter hospital stay than emergency cholecystectomy.

Background: Meniscal tear surgeries have many long term sequelae. Intra-articular platelet rich plasma injection is thought to stimulate repair and increase meniscal function. Objectives: To assess the effect of 6-monthly intra-articular injection of platelet rich plasma (PRP) on the pain assessment and functional status of knee joint undergone meniscal repair. Methods: A randomized controlled trial was carried out on thirty patients who had undergone arthroscopic meniscal repair and presented with persistent pain within 4 months after surgery. Half of the patients were randomly intra-articularly injected with 5 mL PRP at 1 month intervals for 6 injections and the other half were not injected and taken as a control group. Clinical examination, visual analogue scale (VAS), knee injury and osteoarthritis outcome score (KOOS) score and Doppler ultrasonography were performed before and after PRP treatment. Results: After 6 months, in the PRP injected group, there was a significant improvement in VAS score (1 (1 -3)) and KOOS score (86.2 ± 4) compared to baseline values (9 (7 -10) and 62 ± 9.8 respectively; P < 0.001) as well as significant decrease in the percentage of degeneration of medial femoral condyle (MFC), lateral femoral condyle (LFC), medial tibial condyle (MTC), lateral tibial condyle (LTC) measured by Doppler Ultrasonography (US), (6.16 ± 3.33 and 9.07 ± 3.66, respectively; P = 0.031). Conclusions:This study showed that intra-articular PRP injection following meniscal repair can be effective in reducing pain, improving knee function, and slowing the rate of cartilage degeneration that accounts for early osteoarthritis.