Publications by authors named "Mohamed Nour"

28 Publications

  • Page 1 of 1

Endothelial dysfunction in nonalcoholic steatohepatitis with low cardiac disease risk.

Sci Rep 2020 06 1;10(1):8825. Epub 2020 Jun 1.

Liver Research Center, King Saud University, Riyadh, Saudi Arabia.

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. We prospectively evaluated endothelial function by assessing flow-mediated dilatation (FMD) of the brachial artery in patients with biopsy-proven NAFLD. This prospective study included 139 patients (50 healthy controls, 47 patients with steatosis and 42 patients with steatohepatitis), all of whom were nondiabetic. Patients with long-standing or uncontrolled hypertension, smokers, and morbidly obese patients were excluded. The medians (ranges) for vascular FMD in the steatohepatitis, steatosis, and control groups were 6% (0-37.5%), 10.8% (0-40%) and 13.6% (0-50%), respectively. The control group had a higher average FMD than the NAFLD group (15.13% vs 10.46%), and statistical significance was reached when the control and steatohepatitis groups were compared (13.6% vs 6%, p = 0.027). Average alanine aminotransferase was significantly higher in the steatohepatitis group than in the steatosis and control groups (54 (U/L) vs 31 (U/L), p = 0.008). Cholesterol levels were similar between all groups. In the multivariate analysis, FMD (OR = 0.85, p = 0.035) and high triglycerides (OR = 76.4, p = 0.009) were significant predictors of steatohepatitis. In the absence of major cardiac risk factors, we demonstrated better endothelial function in healthy controls, evidenced by a higher FMD of the brachial artery than that of patients with steatohepatitis.
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http://dx.doi.org/10.1038/s41598-020-65835-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264219PMC
June 2020

Neuroanatomical associations of depression, anxiety and apathy neuropsychiatric symptoms in patients with Alzheimer's disease.

Acta Neurol Belg 2020 Apr 21. Epub 2020 Apr 21.

Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, 87 Ding Jiaqiao Rd., Nanjing, 210009, China.

Depression, anxiety and apathy are 'common neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD). We aimed to find regional gray matter (GM) volume difference of these symptoms, in AD patients compared to AD control, and investigate possible associations of GM atrophy with cognitive covariant. Study subjects were retrieved from the Alzheimer's Disease Neuroimaging Initiative database. Thirty-five participants are AD control, 27 AD patients with anxiety, 19 with depression and 24 with apathy, ages ≥ 55.1 years. Recruited subjects had an assessment of their clinical and structural MRI data. GM differences and clinical data were analyzed using voxel-based morphometry and ANOVA with Scheffe post hoc test, respectively. We found significant GM volumes differences in the left insula, left parahippocampal, posterior cingulate and the bilateral putamen in the anxiety group. The results also revealed that the right parahippocampal, Brodmann area 38 and the middle frontal gyrus were significant in patients with depression. Significant results were with a p < 0.05, corrected with AlphaSim program for multiple comparisons. The left insula had a strong negative association with Clinical Dementia Rate Sum of Boxes and Alzheimer's Disease Assessment Scale-cognitive subscale-13 items in anxiety and apathy groups. The difference in GM density in the left insula and hippocampus plays a crucial role in depression, anxiety and apathy NPS and outline precise approaches to test these symptoms.
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http://dx.doi.org/10.1007/s13760-020-01349-8DOI Listing
April 2020

Epidemiological characteristics of a salmonella outbreak among infants in Qatar, 2017.

Qatar Med J 2019 29;2019(3):12. Epub 2019 Nov 29.

Department of Public Health, Ministry of Public Health, Doha, Qatar.

This study was conducted to investigate the epidemiology behind the increased incidence of infant salmonella cases in Qatar during 2017 and identify the possible risk factors. This was a cross-sectional study using the notification reports of laboratory-confirmed infant salmonella cases received by the Ministry of Public Health during the year 2017. Furthermore, complementary phone interviews with the infants' mothers using a validated questionnaire were conducted. The infant salmonella attack rate was calculated at approximately 3.23 cases per 1000 infants. Among the 89 confirmed infant salmonella cases, there were more girls (53%) than boys (47%) with a median age of 8 months. The most common type of salmonella species isolated was group B (50.5%). Among the 59 infant cases whose mothers were interviewed, the majority (94.9%) were symptomatic and diarrhea was the main reported symptom (90%), particularly bloody diarrhoea (62%). Regarding their dietary consumption, the majority (69.5%) of the infected infants were formula-fed. Moreover, the majority reported having no pets at home (91.6%) and were not enrolled in a day care center (93.3%). This study revealed a high incidence of salmonella infection among infants in the State of Qatar, which poses a public health concern. Therefore, targeted interventions and health awareness programs are required for outbreak prevention, detection and control.
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http://dx.doi.org/10.5339/qmj.2019.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883746PMC
November 2019

Cytokines hold promise for human embryo culture in vitro: results of a randomized clinical trial.

Fertil Steril 2019 11 21;112(5):849-857.e1. Epub 2019 Sep 21.

Department of Obstetrics and Gynecology, Sohag University, Sohag, Egypt.

Objective: To evaluate the effects of cytokine enrichment of culture medium on embryological and clinical outcomes after intracytoplasmic sperm injection (ICSI).

Design: A randomized clinical trial.

Setting: In vitro fertilization centers.

Patient(s): This trial included 443 ICSI cycles randomized into two groups.

Intervention(s): This study evaluated the influence of integration of granulocyte-macrophage colony-stimulating factor, heparin-binding epidermal growth factor-like growth factor, and leukemia inhibitory factor into culture media on human embryo development after ICSI.

Main Outcome Measure(s): Ongoing pregnancy rate per a randomized participant.

Result(s): Cytokine enrichment of culture medium showed improvement in ongoing pregnancy rate compared with no cytokines (106/224 [47%] vs. 78/219 [36%]; absolute rate difference [ARD] = 12; 95% confidence interval [CI], 2.5-21). This integration of cytokines also showed better rates of live birth (101/224 [45%] vs. 71/219 [33%]; ARD = 13; 95% CI, 4-21) and cumulative live birth (132/224 [60%] vs. 97/219 [44%]; ARD = 12; 95% CI, 4-20) and lower rate of pregnancy loss (27/124 [22%] vs. 37/103 [36%]; ARD = -14; 95% CI, -26 to -2) than conventional medium. Embryos developed in the cytokine-supplemented medium showed better blastocyst formation, quality, cryopreservation, and use than control medium.

Conclusion(s): Integration of cytokines into human embryo culture media showed improvement in embryological and clinical outcomes after ICSI. However, the long-term effect of cytokine enrichment of a medium is still unclear and warrants further studies with longitudinal follow-up.

Clinical Trial Registration Number: NCT02420886 at ClinicalTrials.gov.
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http://dx.doi.org/10.1016/j.fertnstert.2019.07.012DOI Listing
November 2019

Knowledge and Practice of Emergency Physicians Regarding Food-borne Disease Surveillance at Hamad General Hospital in Qatar.

Cureus 2019 Jun 18;11(6):e4934. Epub 2019 Jun 18.

Preventive Medicine, Cairo University School of Medicine, Cairo, EGY.

Introduction According to the World Health Organization (WHO), foodborne diseases (FBD's) have become a global health issue. In Qatar, foodborne diseases are among the top ten events reported to the Ministry of Public Health. Efforts to enhance FBD surveillance cannot succeed without involving the emergency department (ED), which is typically the first point of contact for the FBD victims with the healthcare system. Therefore, we aimed to explore the knowledge and practices of emergency physicians regarding stool sample collection as part of FBD surveillance efforts in Qatar. Methods A cross-sectional study was conducted at the ED of Hamad General Hospital (HGH) between July 22 and September 12 of 2018. The enrolled participants were invited to participate in an online survey at the "QSurvey" platform. The data was analyzed using Microsoft Excel (Version 2016). Descriptive statistics such as frequency tables, proportions, and percentages were applied as appropriate. Results A total of 65 responses (response rate: 29.27%) were received within the duration of the study. Most participants were specialists (45%), graduated between 2000 and 2013 (64%), and worked for one year or more at HGH-Hamad Medical Corporation (95%). Regarding their knowledge of FBD surveillance, most participants (80%) reported that a stool culture is a necessary laboratory investigation for patients with acute bloody diarrhea and fever. Also, a large percentage of physicians identified salmonella (75%), Clostridium difficile (70%), and E.coli O157:H7 (70%) as pathogens of nationally notifiable diseases. Regarding the respondents' practice towards FBD surveillance, almost three-quarters of the physicians (72%) who encountered a patient with acute diarrhea did not order a stool culture. Subsequently, about two-thirds (62%) of the participants who requested a stool culture reported not following up on the results of such request. Regarding the history taken from patients with acute diarrhea, a large percentage of respondents reported asking about the patient's travel history (100%), presence of any sick contacts (93.6%), and presence of any associated symptoms (abdominal pain, fever, bloody stool) as well as other details. Conclusion The current research identified several gaps regarding the knowledge and practice of emergency physicians towards the surveillance of foodborne disease. Such results serve as a basis for future research and intervention strategies to augment surveillance activities related to food-borne diseases in the State of Qatar.
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http://dx.doi.org/10.7759/cureus.4934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695229PMC
June 2019

The effect of microwave drying pretreatment on dry torrefaction of agricultural biomasses.

Bioresour Technol 2019 Aug 30;286:121400. Epub 2019 Apr 30.

Energy Resources Engineering Department, Egypt-Japan University of Science and Technology (E-JUST), P.O. Box 179-21934, New Borg El-Arab City, Alexandria, Egypt; Mechanical Engineering Department, Faculty of Engineering, Alexandria University, Alexandria 21544, Egypt. Electronic address:

This paper examines the effect of microwave drying on biomass characteristics and subsequent dry pyrolysis and characteristics of produced biochar from rice straw, sugarcane bagasse, rice husk and cotton stalk compared to oven drying at 105 °C. Dried samples from both methods are torrefied at 250 and 300 °C with 30-minutes residence time. Drying time reached 60 times faster with microwave. The fast and violent microwave drying ruptured the biomasses' surface, releasing more volatiles and having lower crystallinity; these lowered the heating value, energy yield and elemental carbon compared to oven drying except for cotton stalk only due to its woody nature which reduced devolatilization. Sugarcane, rice husk and cotton stalk have the most promising values of elemental carbon, energy yield and heating value reaching that of the bituminous coal. Torrefied rice straw showed high crystallinity of 50.7% while sugarcane and rice husk were completely amorphous.
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http://dx.doi.org/10.1016/j.biortech.2019.121400DOI Listing
August 2019

Qatar experience on One Health approach for middle-east respiratory syndrome coronavirus, 2012-2017: A viewpoint.

One Health 2019 Jun 4;7:100090. Epub 2019 Apr 4.

Ministry of Public of Health, Doha, Qatar.

The emergence of the Middle East Respiratory Syndrome Corona Virus (MERS-CoV) in the Middle East in 2012 was associated with an overwhelming uncertainty about its epidemiological and clinical characteristics. Once dromedary camels () was found to be the natural reservoir of the virus, the public health systems across the Arabian Peninsula encountered an unprecedented pressure to control its transmission. This view point describes how the One Health approach was used in Qatar to manage the MERS-CoV outbreak during the period 2012-2017. One Health focuses on the association between the human, animals and environment sectors for total health and wellbeing of these three sectors. To manage the MERS outbreak in Qatar through a One Health approach, the Qatar National Outbreak Control Taskforce (OCT) was reactivated in November 2012. The animal health sector was invited to join the OCT. Later on, technical expertise was requested from the WHO, FAO, CDC, EMC, and PHE. Subsequently, a comprehensive One Health roadmap was delivered through leadership and coordination; surveillance and investigation; epidemiological studies and increase of local diagnostic capacity. The joint OCT, once trained had easy access to allocated resources and high risk areas to provide more evidence on the potential source of the virus and to investigate all reported cases within 24-48 h. Lack of sufficient technical guidance on veterinary surveillance and poor risk perception among the vulnerable population constituted major obstacles to maintain systematic One Health performance.
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http://dx.doi.org/10.1016/j.onehlt.2019.100090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462540PMC
June 2019

Survey on Implementation of One Health Approach for MERS-CoV Preparedness and Control in Gulf Cooperation Council and Middle East Countries.

Emerg Infect Dis 2019 03;25(3)

In 2015, a One Health Working Group was established in Qatar to conduct a survey in the Gulf Cooperation Council countries, Egypt, and Jordan to monitor preparedness of public health and veterinary health authorities in response to the Middle East respiratory syndrome coronavirus epidemic. All but 1 country indicated they established joint One Health policy teams for investigation and response. However, the response to the questionnaires was largely limited to veterinary authorities. Critical barriers and limitations were identified. National and regional leaders, policy makers, and stakeholders should be prompted to advocate and enhance adoption of the One Health framework to mitigate the risk for Middle East respiratory syndrome and other emerging zoonotic diseases.
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http://dx.doi.org/10.3201/eid2503.171702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390738PMC
March 2019

Knowledge, Attitude, and Practice Regarding Zika Among Travelers to Brazil: Qatar's Airport Study 2017.

Cureus 2018 Sep 10;10(9):e3280. Epub 2018 Sep 10.

Epidemiology and Public Health, Ministry of Public Health, Doha, QAT.

Background The Zika virus has become an international health issue and poses a systematic risk for a growing number of travelers. Qatar is no exception to this status, where its Hamad International Airport (HIA) has become an important hub for many travelers to and from affected countries. Thus, it is a national necessity to determine the knowledge, attitude, and practice of travelers' regarding this emerging disease in the State of Qatar. Methods This was a cross-sectional study that employed a self-administered questionnaire (n=100) and was conducted at Hamad International Airport. Descriptive and inferential statistical tests were applied to analyze the data using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics 21, IBM Corporation, Armonk, NY, USA, 2014). Results The majority of travelers (75%) reported hearing about the Zika disease prior to their current flight, mainly from the media (73%) and the internet (46%). The majority of participants (69%) knew about the vector-borne transmission and symptomatology of a Zika infection while more than half (54%) correctly identified effective methods to prevent infection. Regarding their attitude, less than two-thirds (58%) of the participants agreed that pregnant women must postpone their travel to any Zika-affected area. Regarding their practice, only a quarter of the sampled travelers (24%) sought pre-travel medical advice before going to Brazil. Comparing the knowledge score among different education levels, we found that high-school students scored significantly better than those with diplomas and bachelors, p=0.042 and p=0.012, respectively. Conclusion The survey findings revealed that the knowledge of Zika infection is low among travelers to Brazil. Thus, stronger efforts to educate travelers about Zika are recommended. It is also vital that travelers be encouraged to seek proper medical advice prior to travel.
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http://dx.doi.org/10.7759/cureus.3280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333323PMC
September 2018

Drivers of MERS-CoV Emergence in Qatar.

Viruses 2018 12 31;11(1). Epub 2018 Dec 31.

Department of Viroscience, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.

MERS-CoV (Middle East respiratory syndrome corona virus) antibodies were detected in camels since 1983, but the first human case was only detected in 2012. This study sought to identify and quantify possible drivers for the MERS-CoV emergence and spillover to humans. A list of potential human, animal and environmental drivers for disease emergence were identified from literature. Trends in possible drivers were analyzed from national and international databases, and through structured interviews with experts in Qatar. The discovery and exploitation of oil and gas led to a 5-fold increase in Qatar GDP coupled with a 7-fold population growth in the past 30 years. The lifestyle gradually transformed from Bedouin life to urban sedentary life, along with a sharp increase in obesity and other comorbidities. Owing to substantial governmental support, camel husbandry and competitions flourished, exacerbating the already rapidly occurring desertification that forced banning of free grazing in 2005. Consequently, camels were housed in compact barns alongside their workers. The transition in husbandry leading to high density camel farming along with increased exposure to humans, combined with the increase of camel movement for the racing and breeding industry, have led to a convergence of factors driving spillover of MERS-CoV from camels to humans.
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http://dx.doi.org/10.3390/v11010022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356962PMC
December 2018

Engagement of health research institutions in knowledge translation in the Eastern Mediterranean Region.

East Mediterr Health J 2018 Sep 6;24(7):672-679. Epub 2018 Sep 6.

Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.

Background: Health research institutions in the Eastern Mediterranean Region (EMR) can play an integral role in promoting and supporting Knowledge Translation (KT). Assessing institutions' engagement in KT and bridging the "research- policy" gap is important in designing context-specific strategies to promote KT and informing funding efforts in the region.

Aims: The objective of this study was to explore the engagement of EMR institutions in KT activities.

Methods: A cross-sectional survey of institutions undertaking health research in the 22 EMR countries was undertaken. The survey covered institutional characteristics, institutional planning for research, national planning for health research, and knowledge management, translation and dissemination.

Results: 575 institutions were contacted of which 223 (38.3%) responded. Half the sampled institutions reported conducting priority-setting exercises, with 60.2% not following a standardized approach. Less than half institutions reported frequently/ always (40.5%) involving policymakers and stakeholders in setting priorities for research on health. Only 26.5% of respondent institutions reported that they examine the extent to which health policymakers utilize their research results. Moreover, only 23.3% reported measuring the impact of their health research.

Conclusions: There is still misalignment between national health research priorities and actual research production, and KT activities are still rarely undertaken by institutions in the EMR. National governments and international funding agencies are called to support research production and translation in the EMR. Institutions and researchers are also called to produce policy-relevant research and be responsive to the needs and priorities of policy-makers.
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http://dx.doi.org/10.26719/2018.24.7.672DOI Listing
September 2018

Molecular characterization of isolates from pulmonary tuberculosis patients in Khartoum, Sudan.

Int J Mycobacteriol 2018 Jul-Sep;7(3):236-241

Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden.

Background: The aim of this study was to characterize the drug resistance profile, and the specific lineages of Mycobacterium tuberculosis (MTB) strains isolated from patients with pulmonary TB in the state of Khartoum in Sudan.

Methods: Consecutive sputum samples and clinical data were collected from 406 smear-positive TB patients with pulmonary TB in 2007-2009. The samples were cultured, and drug susceptibility testing (DST) was performed using the proportion method (PM) on solid Löwenstein-Jensen medium, and species were identified using biochemical methods at the National Reference Laboratory (NRL) in Khartoum. Extracted deoxyribonucleic acid from a total of 120, 60 suspected multidrug-resistant isolates (MDR), and 60 non-MDR isolates were subsequently sent to the WHO supranational reference laboratory (SRL) in Stockholm at the Public Health Agency of Sweden, for confirmation of the drug resistance profile, examinations by line probe assay (LPA), and molecular epidemiology analysis with Spoligotyping.

Results: LPA results correlated 100% for non-MDR and 62% for the suspected MDR strains when compared to the DST results obtained by PM at the NRL. Two strains were initially using the PM identified as MDR-TB but later shown by Hain GenoType Mycobacterium CM/AS to belong Mycobacterium avium complex (Mycobacterium intracelluare). These two strains were excluded from the study material for further analysis. The remaining 58 MDR strains were analyzed using LPA, and 36 strains were confirmed as MDR, 10 as rifampicin monoresistant, and eight as isoniazid-monoresistant. Spoligotyping for all the 118 MTB isolates revealed a total of 115 patterns in which four patterns represented major clusters with a total of 108 (91%) of the strains. The CAS1_Delhi/family was the predominant type and detected in 62 isolates (52%), of which 26 were MDR and 36 were susceptible. It was followed by H3/family with 19 (16%) strains, and 11 Latin American Mediterranean3/family, 16 T2/T1, and two strains each of the Beijing and S lineage.

Conclusion: Comparison of DST results obtained using PM and LPA showed 100% agreement for the non-MDR strains but only 62% for the MDR strains. Taking in consideration the time, risk of contamination and the cost of labour to identify MDR TB, the LPA have clear advantages in early detection of MDRTB than the PM. Additionally in this study material Spoligotyping revealed the CAS1 Delhi as the most predominant family. We could not see no major difference in lineages between MDR and non-MDR strains.
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http://dx.doi.org/10.4103/ijmy.ijmy_82_18DOI Listing
May 2019

Health research institutional mapping: an Eastern Mediterranean Regional perspective.

East Mediterr Health J 2018 May 3;24(2):189-197. Epub 2018 May 3.

Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.

Background: Research-conducive environments are mandatory for planning, implementing and translating research findings into evidence-informed health policies.

Aim: This study aimed at comprehensive situation analysis of health research institutions in the Region.

Methods: We collected data on: institutional characteristics, research scope, capacity building, ethics, governance and resources.

Results: We contacted 575 institutions, of which, 223 (38.8%) responded, indicating that they conducted population research (82%). Reported studies were mostly in medicine, public health and epidemiology, while reported capacity building mainly focused on scientific writing (20.6%), research proposal writing (18%) and quantitative research methods (17%). Most institutions reported having collaborating partners (82%) - predominantly national (77%). Sixty-four percent of institutions received their own funding, with 48% reporting always having access to national databases.

Conclusion: Governments in the Eastern Mediterranean Region and international funding agencies are called upon to support health research production through increasing allocated support and capacity building in health research.
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May 2018

How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak.

Int J Environ Res Public Health 2017 12 19;14(12). Epub 2017 Dec 19.

Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.

This case study is the first to be developed in the Middle East region to document what happened during the response to the 2013 MERS outbreak in Qatar. It provides a description of key epidemiologic events and news released from a prime daily newspaper and main Emergency Risk Communication (ERC) actions that were undertaken by public health authorities. Using the Crisis and Emergency Risk Communication (CERC) theoretical framework, the study analyzes how the performed ERC strategies during the first days of the outbreak might have contributed to the outbreak management.

Methods: MERS-CoV related events were chronologically tracked, together with the relevant stories that were published in a major newspaper over the course of three distinct phases of the epidemic. The collected media stories were then assessed against the practiced emergency risk communication (ERC) activities during the same time frame.

Results: The Crisis & Emergency Risk Communication (CERC) framework was partially followed during the early days of the MERS-CoV epidemic, which were characterized by overwhelming uncertainty. The SCH's commitment to a proactive and open risk communication strategy since day one, contributed to creating the SCH's image as a credible source of information and allowed for the quick initiation of the overall response efforts. Yet, conflicting messages and over reassurance were among the observed pitfalls of the implemented ERC strategy.

Conclusion: The adoption of CERC principles can help restore and maintain the credibility of responding agencies. Further work is needed to develop more rigorous and comprehensive research strategies that address sharing of information by mainstream as well as social media for a more accurate assessment of the impact of the ERC strategy.
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http://dx.doi.org/10.3390/ijerph14121597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751014PMC
December 2017

Raising awareness of health care providers about MERSCoV infection in public hospitals in Mecca, Saudi Arabia.

East Mediterr Health J 2017 Oct 30;23(8):534-542. Epub 2017 Oct 30.

Department of Health Education and Promotion, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia.

It is important that health care workers have good knowledge, attitudes and practices (KAP) towards MERS-CoV, especially in Mecca because of the MERS-CoV threat during hajj and umrah. This study aimed to assess KAP of health care providers in public hospitals in Mecca about MERS-CoV infection and evaluate the effectiveness of a health education intervention to improve KAP. KAP was assessed among 281 participants using a self-administered questionnaire who then underwent the health education intervention using a combination of methods. After 3 months, 188 participants responded to the post-intervention evaluation. Significant post-intervention improvement was found in the median scores for knowledge (P < 0.001), attitude (P = 0.022) and cumulative KAP (P < 0.001); scores improved irrespective of age group and gender. Practice scores did not improve significantly, although reported practices were good before the intervention. The positive effects of the intervention support efforts to continuously implement health education interventions for health care providers in Mecca.
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October 2017

Premature atherosclerosis in children with beta-thalassemia major: New diagnostic marker.

BMC Pediatr 2017 03 9;17(1):69. Epub 2017 Mar 9.

Pediatrics Department, Zagazig University, Zagazig, Egypt.

Background: Early vascular alteration, atherosclerosis and coronary artery disease have emerged as important cardiovascular complications among beta-thalassemia major (B-TM) patients. The aims of the current study were to assess the prevalence of premature atherosclerosis among our B-TM patients, and to investigate the diagnostic value of serum Osteoprotegerin assay as an early biomarker for atherosclerosis.

Methods: This cross-sectional study was conducted at Hematology unit - Pediatric Department, Zagazig University Children Hospital- Egypt in the period from March 2014 to March 2015. A total of 115 children were enrolled in the current study; as sixty-five (65) children with beta thalassemia major aged 5-18 years, on regular blood transfusion regimen represented the patient group. While fifty (50) healthy children, with comparable age and gender, were assigned as control group. All participants were subjected to history taking, thorough clinical examination and laboratory investigations including; complete blood count, liver and kidney function tests, C- reactive protein, lipid profile, serum ferritin and serum Osteoprotegerin (OPG) assay. Also, carotid artery intima media thickness (CAIMT) was performed by duplex ultrasound for patients and controls.

Results: Our B-TM patients were transfusion-dependent for as long as 8.5 ± 3.8 years with significantly higher serum ferritin levels (2490 ± 1579 ng/dl vs 83 ± 32 ng/dl, p = 0.001), C-reactive protein (5.7 ± 5.7 vs 0.9 ± 0.9), liver enzymes and bilirubin when compared to controls. Significantly higher serum triglyceride (128 ± 20 vs 101 ± 7 mg/dL, p = 0.009) and atherogenic index of plasma (0.45 ± 0.12 vs 0.22 ± 0.04, p = 0.001) were recorded in patients than comparisons. On the contrary, total serum cholesterol (116 ± 16 vs 143 ± 5, p < 0.001), low density lipoprotein-cholesterol (LDL-C) (44 ± 9 vs 73 ± 6, p < 0.001) and high density lipoprotein cholesterol (HDL-C) (39 ± 2 vs 61 ± 5, p < 0.001), were significantly lowered in patients versus normal peers. Carotid arteries intima media thickness (CAIMT) of both side were significantly increased for patients (Rt 0.62 ± 0.2 vs. 0.29 ± 0.07 mm, p = 0.001 & Lt 0.66 ± 0.17 vs 0.29 ± 0.05 mm, p = 0.001) when compared with healthy controls, and showed positive correlation with, serum triglyceride, atherogenic index of plasma, and serum Osteoprotegerin levels. ELISA assay of serum Osteoprotegerin (OPG) revealed significantly higher levels for thalassemia patients than matched healthy controls (427 ± 102 vs. 324 ± 126 pg/ml, p = 0.02). Of particular interest is the obvious positive correlation between OPG levels and CAIMT of both sides (Rt r 0.54, p = 0.001 &Lt r 0.479, p = 0.001) and also with serum triglycerides (r 0.374, p = 0.03).

Conclusions: Subclinical atherosclerosis started prematurely in children with beta- thalassemia. Carotid artery intima media thickness represented a simple, accurate and non-invasivemodality for early detection ofatherosclerosis. It was correlated well with serum Osteoprotegerin; this finding highlighted the possible validity of OPG assay as an early predictor of atherosclerosis in thalassemia children.
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http://dx.doi.org/10.1186/s12887-017-0820-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345217PMC
March 2017

Integrating insulin into single-step culture medium regulates human embryo development in vitro.

Fertil Steril 2017 02 1;107(2):405-412. Epub 2016 Dec 1.

Department of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Sohag, Egypt.

Objective: To evaluate the effect of supplementing single-step embryo culture medium with insulin on human embryo development.

Design: Comparative study.

Setting: Two private centers.

Patient(s): The study involved a sibling oocyte split of 5,142 retrieved oocytes from 360 patients.

Intervention(s): Sibling oocytes split after intracytoplasmic sperm injection for culture from day 0 through day 5 or 6 in insulin-supplemented or control medium. Women were split to receive their embryos from insulin-supplemented or control medium.

Main Outcome Measure(s): Clinical pregnancy rate.

Result(s): There were significantly higher rates of clinical, ongoing, and twin pregnancies in the insulin-supplemented arm than in the control arm. On day 3, embryo quality and compaction were higher in insulin-supplemented medium. On day 5, insulin supplementation showed higher rates of blastocyst formation, quality, and cryopreservation.

Conclusion(s): Insulin supplementation of single-step embryo culture medium from day 0 through day 5 or 6 improved clinical pregnancy rate and human embryo development. However, these findings need further confirmation through a multicenter randomized controlled trial that may include other patient populations and different culture media.
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http://dx.doi.org/10.1016/j.fertnstert.2016.11.003DOI Listing
February 2017

PET radiotracer development for imaging high-affinity state of dopamine D2 and D3 receptors: Binding studies of fluorine-18 labeled aminotetralins in rodents.

Synapse 2017 03 30;71(3). Epub 2016 Nov 30.

Department of Radiological Sciences, Preclinical Imaging Center, University of California-Irvine, Irvine, California, 92697, USA.

Imaging the high-affinity, functional state (HA) of dopamine D2 and D3 receptors has been pursued in PET imaging studies of various brain functions. We report further evaluation of F-5-OH-FPPAT, and the newer F-5-OH-FHXPAT and F-7-OH-FHXPAT. Syntheses of F-5-OH-FHXPAT and F-7-OH-FHXPAT were improved by modifications of our previously reported procedures. Brain slices and brain homogenates from male Sprague-Dawley rats were used with the 3 radiotracers (74-111 kBq/cc). Competition with dopamine (1-100 nM) and Gpp(NH)p (10-50 µM) were carried out to demonstrate binding to dopamine D2 and D3 HA-states and binding kinetics of F-5-OH-FPPAT measured. Ex vivo brain slice autoradiography was carried out on rats administered with F-5-OH-FHXPAT to ascertain HA-state binding. PET/CT imaging in rats and wild type (WT) and D2 knock-out mice were carried out using F-7-OH-FHXPAT (2-37 MBq). Striatum was clearly visualized by the three radiotracers in brain slices and dopamine displaced more than 80% of binding, with dissociation rate in homogenates of 2.2 × 10 min for F-5-OH-FPPAT. Treatment with Gpp(NH)p significantly reduced 50-80% striatal binding with faster dissociation rates (5.0 × 10 min ), suggesting HA-state binding of F-5-OH-FPPAT and F-5-OH-FHXPAT. Striatal binding of F-5-OH-FHXPAT in ex vivo brain slices were sensitive to Gpp(NH)p, suggesting HA-state binding in vivo. PET binding ratios of F-7-OH-FHXPAT in rat brain were ventral striatum/cerebellum = 2.09 and dorsal striatum/cerebellum = 1.65; similar binding ratios were found in the D2 WT mice. These results suggest that in vivo PET measures of agonists in the brain at least in part reflect binding to the membrane-bound HA-state of the dopamine receptor.
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http://dx.doi.org/10.1002/syn.21950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363407PMC
March 2017

Clinical presentations and outcome of severe community-acquired pneumonia.

Egypt J Chest Dis Tuberc 2016 Oct 18;65(4):831-839. Epub 2016 Jun 18.

Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt.

Background: Severe community-acquired pneumonia (SCAP) represents a frequent and potentially life-threatening condition. About 10% of all hospitalized patients with CAP require admission to the intensive care unit (ICU), and the mortality of these patients reaches 20-50%.

Objective: To evaluate the clinical presentation, bacteriological profile and outcome of severe community-acquired pneumonia (SCAP).

Patients And Methods: 54 patients presented by symptoms and sign of severe community acquired pneumonia who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital from August 2015 to March 2016 were subjected to full clinical examination, chest X ray, complete blood picture, sputum and blood culture, PCR for suspected cases of Influenza H1N1 and MERS-COV, treatment, follow up, data collections and statistical analysis.

Results: The present study included 54 patients 26 males and 28 females with SCAP who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital. The most common comorbidities were diabetes mellitus and hypertension. The most common presentations were fever, cough, dyspnea and hypoxemia. Two patients developed renal failure and 4 patients developed septic shock. The most common isolated organism was , Influenza H1N1, and . Mortality was 24% and it was common in patients with comorbidity than in patients without comorbidities.

Conclusion: SCAP occurs more frequently in those with comorbidities. The most frequent isolated causative organism of SCAP is , Influenza H1N1 and . SCAP is associated with significant mortality, early recognition and prompt treatment may improve outcome.
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http://dx.doi.org/10.1016/j.ejcdt.2016.06.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125902PMC
October 2016

Antimicrobial Activities of Some Actinomycetes Isolated from Different Rhizospheric Soils in Tunisia.

Curr Microbiol 2016 Aug 2;73(2):220-7. Epub 2016 May 2.

High Institute of Biotechnology, Monastir, Tunisia.

Fifty four isolates of actinomycetes were collected from four different rhizospheric soils: 18 strains from palm tree bark and soil, 12 strains from an olive field soil, 9 strains from a coastal forest, and 15 strains from an agriculture soil situated in the Algerian-Tunisian border (Oum Tboul). Based on morphological and cultural characters, the isolates were classified as Streptomyces (42 strains), Micromonospora (4 strains), Pseudonocardia (1 strain), Actinomadura (1 strain), Nocardia (1 strain), and non-Streptomyces (5 strains). More than half of the isolates inhibited at least one tested pathogenic microorganisms in liquid culture. In addition, antimicrobial activities of some strains were tested on solid culture. Several bioactive compounds were identified by liquid chromatography joined with low-resolution mass spectroscopy (LC/MS) and analysed by MEDINA's database and by the dictionary of natural products Chapman & Hall. An interesting chlorinated compound with the molecular formula C20H37ClN2O4, produced by three different strains (SF1, SF2, and SF5), was subject of an attempted purification. However, it was demonstrated using confocal microscopy and LC/MS high resolution that this compound is produced only on solid culture. These three potential antimicrobial isolates showed high similarity with Streptomyces thinghirensis and Streptomyces lienomycini, in terms of morphological characteristics and 16S rRNA gene sequences (bootstrap 97 %). All these findings prove the high antimicrobial diversity of the studied soils. The potential of the selected and other relatively unexplored extreme environments constitute a source of interesting actinomycete strains producing several biologically active secondary metabolites.
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http://dx.doi.org/10.1007/s00284-016-1053-5DOI Listing
August 2016

The value of combined use of survivin mRNA and matrix metalloproteinase 2 and 9 for bladder cancer detection in voided urine.

Dis Markers 2013 ;34(1):57-62

Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. dr sanaa

Objective: In a trial to improve the diagnostic efficacy of conventional urine cytology we determine survivin RNA and matrix metalloproteinase 2 and 9 in urine of bladder cancer cases.

Method: Voided urine specimens were collected from patients with histologically confirmed bladder urothelial carcinoma (Group 1; n=46), urological patients without urothelial carcinoma (Group 2; n=20), and healthy volunteers (Group 3; n=20). Urine cytology, survivin RNA was estimated by qualitative nested RT-PCR and MMP-2, MMP-9 activity were detected by gelatin zymography. The expression of survivin RNA and matrix metalloproteinase 2 and 9 in bladder cancer was compared with benign and normal cases.

Results: Positivity rates of survivin RNA and MMPs zymography were significantly different among the 3 groups. Urine survivin detection by qualitative nested RT-PCR showed 76.1% sensitivity and 95% specificity. The overall sensitivity, specificity of urinary MMP zymography was 67.3%, 90% respectively. The combined use of urine cytology with urine survivin or MMPs zymography increased sensitivity of urine cytology from 50% to 84.7%. The highest sensitivity (95.6%) was obtained on combining the three markers.

Conclusion: Survivin RNA and MMPS zymography can be considered as promising noninvasive markers for bladder cancer early detection. Combined use of the three markers improved the sensitivity for detecting bladder cancer.
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http://dx.doi.org/10.3233/DMA-2012-0923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810229PMC
May 2013

Association of the Met-196-Arg variation of human tumor necrosis factor receptor 2 (TNFR2) with paranoid schizophrenia.

J Mol Neurosci 2011 Mar 15;43(3):358-63. Epub 2010 Sep 15.

05UR/09-11, Institut Supérieur de Biotechnologie de Monastir, Monastir, Tunisia.

Research has provided strong evidence for oligodendrocyte and myelin-related genes dysfunction in schizophrenia. Several studies have suggested abnormalities in the expression of myelin-related genes including tumor necrosis factor receptor 2 (TNFR2) involved in the neurodegeneration and remyelination. In order to further assess the role of TNFR2 in schizophrenia, we examined a functional bi-allelic polymorphism associated with an impaired NF-KB signaling and cell survival. In the present case/control study, 220 patients with schizophrenia and 176 healthy controls were genotyped by RFLP-PCR for the T/G polymorphism at the position 676 in exon 6 of the TNFR2 gene. We found a trend towards over-representation of TNFR2 676G in the patients compared to the controls (p=0.19 and 0.09 respectively). Interestingly, when we evaluated the association between this genetic polymorphism and the clinical variables of schizophrenia, our findings indicated that the frequencies of the G/G genotype and the G allele were significantly higher in paranoid (p=0.014 and p=0.012 respectively) and adult-onset paranoid (p=0.004 and p=0.004 respectively) schizophrenia patient group compared to the controls. The potential association was confirmed by a logistic regression model only for development of the paranoid form of schizophrenia (p=0.022) indicating a substantially increased risk for paranoid schizophrenia with inheritance of the TNFR2(G) allele. In conclusion, this polymorphism in TNFR2 or a gene in proximity seems to be associated specifically with paranoid schizophrenia, at least in the Tunisian population. A replication of our findings in other and larger populations could be of particular importance to establish TNFR2 as one of the susceptibility genes of paranoid schizophrenia.
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http://dx.doi.org/10.1007/s12031-010-9450-xDOI Listing
March 2011

Characterization of ST80 Panton-Valentine leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus clone in Tunisia.

Diagn Microbiol Infect Dis 2013 Sep 3;77(1):20-4. Epub 2008 Apr 3.

High Institute of Biotechnology, Medical Biotechnology, Monastir, UR-09-11, Tunisia 5000, Tunisia.

The spread of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has been reported in communities worldwide. In this study, we characterized 64 Tunisian CA-MRSA by agr typing, polymerase chain reaction assay for 20 virulence genes, staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and protein A gene (spa) typing. All our isolates were lukS-PV-lukF-PV positive, etd positive, and edin positive. They harbored SCCmec type IV and belonged to agr group 3. PFGE typing showed that our isolates were distributed in 11 different pulsotypes. spa typing and MLST, performed with isolates representative of each PFGE pattern, revealed that all isolates had a unique spa type (t044) and a common sequence type (ST80). The isolates showed susceptibility to the majority of antibiotics, and resistance to kanamycin, erythromycin, and tetracycline, but intermediate resistance to fusidic acid. Full analysis of our results revealed that our isolates were nonmultiresistant and belonged to a single clonal type ST80.
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http://dx.doi.org/10.1016/j.diagmicrobio.2008.02.010DOI Listing
September 2013

Molecular characterization of methicillin-resistant Staphylococcus aureus isolated in Tunisia.

Diagn Microbiol Infect Dis 2006 May 23;55(1):21-6. Epub 2006 Feb 23.

Institut Supérieur de Biotechnologie, 5000 Monastir, Tunisia.

Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections are an emerging problem, especially related to the production of staphylococcal toxins. In this study we investigate the phenotypic and genotypic characteristics of 72 Tunisian MRSA. Our results revealed that these strains are multiresistant. Using multiplex polymerase chain reaction, we detected staphylococcal cassette chromosome mec (SCCmec) type IV and IVA in 66 isolates. The latter are Panton-Valentine leukocidin positive. The leukotoxin genes lukE-lukD were found in most strains (92.4%). The amplification of gamma-hemolysin gene was detected only in 2 MRSA isolates. Among all strains, only 1 expressed the exfoliatin A. fnbA gene was detected in 12 strains, fnbB gene in 2 strains, and both fnbA and fnbB genes in 2 other strains. The most predominant accessory gene regulator group identified was group III. Full characterization of these MRSA strains requires the association of SCCmec typing with other molecular methods such as pulsed-field gel electrophoresis, multilocus-sequence typing, and spa typing.
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http://dx.doi.org/10.1016/j.diagmicrobio.2005.10.017DOI Listing
May 2006

[Methicillin resistance in Staphylococcus aureus: emergence and molecular basis].

Pathol Biol (Paris) 2005 Jul;53(6):334-40

Laboratoire de Microbiologie, Institut Supérieur de Biotechnologie de Monastir, B. P. 74, avenue de l'Environnement, 5000 Monastir, Tunisie.

Methicillin-resistant Staphylococcus aureus (MRSA) is often the severe causal agent in nosocomial infections that are becoming increasingly difficult to cure because of emerging resistance to all current antibiotic classes. Geographic spread of several MRSA clones between countries and continents has been reported and proven by molecular evidence. Several strains have been isolated from patients in the community without established risk factors for MRSA acquisition. Some of them may have origins in the hospital but others appear to be community-acquired strains. Community MRSA strains have several distinguishing characteristics that may enable them to more readily colonize and infect otherwise healthy hosts. Molecular typing approaches have been used with great advantage in studying of the MRSA epidemiology. It appears that a complete characterization of MRSA requires not only identification of the genetic background of the bacteria but also identification of the structural types of Staphylococcal Cassette Chromosome mec element (SCCmec), which carries methicillin resistance determinant mecA. Rapid and precise identification of MRSA is a prerequisite for control of hospital infections. This article reviews recent publications addressing the epidemiology markers of MRSA, specially of community-acquired strains, and the genetic diversity of SCCmec for identifying MRSA. It appears that MRSA will be an increasing important pathogen in the community.
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http://dx.doi.org/10.1016/j.patbio.2004.08.001DOI Listing
July 2005

Amplification of P1 and 16S rRNA genes by nested PCR for detection of Mycoplasma pneumoniae in paediatric patients.

Pathol Biol (Paris) 2005 Feb;53(1):9-14

Laboratoire de Microbiologie, Institut Supérieur de Biotechnologie de Monastir, B.P. 74, Avenue de l'Environnement, 5000 Monastir, Tunisia.

Mycoplasma (M.) pneumoniae is the most frequent atypical pathogen responsible for community-acquired respiratory infection in children and adults. The etiologic diagnosis of these infections still remains difficult. This is mainly due to the absence of characteristic clinical findings, and to the available detection methods (serology and culture) which are time consuming, insensitive and non-specific. To improve the detection of this infectious agent, nested polymerase chain reaction (PCR) analysis was developed. A total of 46 nasal aspirates, from children hospitalised with severe lower respiratory tract infection and in whom M. pneumoniae was suspected, were analysed for the presence of M. pneumoniae DNA by PCR. Routine microbiological investigations revealed no virus in these 46 samples. Using nested PCR, two targets were amplified: the sequences of 16S ribosomal (r) RNA gene (rDNA) and P1 adhesin gene. Evidence of M. pneumoniae infection was identified in four paediatric patients. The amplification of 16S rDNA was found to be more sensitive for the detection of M. pneumoniae. Our results suggest that amplification of the 16S rDNA by nested PCR and detection of the amplification products by visual inspection of the polyacrylamide gel should allow the rapid diagnosis of M. pneumoniae in respiratory tract infection in paediatric patients.
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http://dx.doi.org/10.1016/j.patbio.2004.01.002DOI Listing
February 2005

Prevalence in a Tunisian Arabic population of factor VII DNA variants and relation to factor VII plasma levels.

Clin Chim Acta 2004 Nov;349(1-2):199-202

Faculty of Medicine, 99-UR/08-39, Monastir, Tunisia.

Background: A raised plasma factor VII (FVII) level is a risk factor for coronary heart disease. DNA variants have been described to be associated with alteration in FVII levels. The prevalence of FVII polymorphisms is unknown in the Tunisian Arab population.

Methods: In a group of 240 healthy Tunisians, we examined the relationship between levels of FVII coagulant activity (FVIIc) and two polymorphisms in the FVII gene. One polymorphism alters arginine at position 353 to glutamine (R/Q) and the other is a 10 base pair insertion (0/10 bp).

Results: The FVII distribution was in accordance with the Hardy-Weinberg equilibrium. The allele frequencies of Q and 10 bp were 0.212 and 0.235, respectively. There were significant differences in these allelic frequencies between Tunisian and other populations (p<0.001). We observed lower FVIIc levels among subjects with the Q allele compared to RR subjects (RR: 98.17%, RQ/QQ: 57.41%, p<0.0001). For the 0/10 polymorphism, no statistically difference was observed.

Conclusion: The prevalence of the Q allele which was found to be associated with lower plasma FVIIc levels is high in Tunisian population. Further analyses should yield information on the protective role of carrying the Q allele for coronary heart disease.
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http://dx.doi.org/10.1016/j.cccn.2004.06.025DOI Listing
November 2004

In vitro developmental potential of bovine nuclear transfer embryos derived from primary cultured cumulus cells.

J Vet Med Sci 2000 Mar;62(3):339-42

Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.

The in vitro development and the quality of blastocysts produced from the nuclear transfer (NT) embryos reconstituted from primary cultured cumulus cells (NT-cumulus) were examined compared to in vitro fertilized embryos (IVF) and NT embryos reconstituted from the embryonic blastomeres (NT-blastomere). The cleavage rate, and the development to blastocyst were the same for all three sets of embryos. The time required for blastocoel formation starting from the time of the initial cleavage was shorter for NT embryo groups than IVF ones. All experimental groups produced morphologically similar and normal blastocysts containing the same cell number. The percentage of the blastocysts with normal chromosomal complements were the same for NT-cumulus and IVF.
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http://dx.doi.org/10.1292/jvms.62.339DOI Listing
March 2000