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OBJECTIVE: Diabetes mellitus (DM) has been considered a major problem because of its related complications and growing incidence worldwide. Testicular dysfunction has become a predominant diabetic complication characterized by impaired reproductive function and testicular damage. Stevia rebaudiana Bertoni has been known for its antioxidant effect on diabetes, inflammation, and obesity. The current study investigates the protective effect of Stevia on diabetic-induced testicular injury. MATERIALS AND METHODS: Sprague Dawley adult male rats were divided into three groups: the control group, the diabetic group, and the diabetic + Stevia group, type 2 diabetes is induced by a high-fat diet (HFD) and a single dose of 35 mg/kg streptozotocin injection. The effects of Stevia were evaluated regarding biochemical, oxidative stress, histopathological and ultrastructural changes, and immunohistochemical expression of vascular endothelial growth factor (VEGF), vascular cell adhesion molecule-1 (VCAM-1), receptor-interacting serine/threonine-protein kinase 1 (RIPK 1), and caspase 3. RESULTS: Stevia extract attenuated the diabetic-induced oxidative stress, restored the testicular architecture, and decreased testicular damage, inflammation, necroptosis, and apoptosis by upregulating VEGF and downregulating VCAM 1, RIPK 1, and caspase 3. CONCLUSIONS: The current study highlights the importance of Stevia as an antioxidant anti-inflammatory that ameliorates diabetic-induced testicular injury by modulating oxidative stress, inflammation, necroptosis, and apoptosis.

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1. A total of 150-day-old chicks were divided into three groups of 50 birds (G1-G3); G1 and G2 were orally inoculated at 1-day old with 0.5 ml of 107 TCID50/ml FAdV-D serotype 2 (MT386509.1) and FAdV-E serotype 8a (MW847902), respectively, and G3 was blank control group.2. Cell-mediated immune response was evaluated by detection of CD4, CD8 T lymphocytes and the mRNA expression of IL6 and IL8 in the chicken spleen using q-PCR. Additionally, immunopathology was performed at 3, 5 and 7 day post infection (dpi) and weekly until the end of the experiment.3. Results revealed that transcription of inflammatory cytokines (IL6, IL8) was up regulated in the spleen of FAdV type D and type E infected chickens at various time points relative to the control group. A marked decrease in the number of CD4 and CD8 T lymphocytes at 5 and 7 dpi in G1 of chickens infected with FAdV type D. Whereas, in chickens infected with FAdV type E, the CD4 and CD8 T lymphocytes were markedly decreased at 7 dpi.4. In contrast, there were no significant differences in humoral immune responses against NDV vaccine in (G1 and G2) at different intervals post-vaccination compared to the control group. The histopathology of the bursa, thymus, and spleen in the infected groups showed lymphocytolysis with severe reticular cells hyperplasia and lymphoid depletion.5. In conclusion, fowl adenovirus types D and E have an immunosuppressive effect in broilers which may be considered one of the main causes of the continuous co-infections with other viruses reported in the field during the last 10 years.

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The aim of this randomised prospective study was to assess the efficacy of early thromboprophylaxis with low-molecular weight heparin (LMWH) in women with a history of recurrent first trimester spontaneous abortion or miscarriages without identifiable causes vs no treatment. The study comprised of 340 women with unexplained spontaneous recurrent miscarriages. Patients in group A were prescribed LMWH (Enoxaparin sodium 0.2 ml, 20 mg, once daily subcutaneously) from the time of confirmation of fetal viability by ultrasonography until 34 weeks' gestation, and folic acid tablets 0.5 mg daily until 13 weeks' gestation. Patients in group B were given folic acid tablets 0.5 mg daily until 13 weeks' gestation. Termination of pregnancy was the primary outcome. There was a significant difference in the incidence of both early (4.1% vs 8.8%) and late miscarriages (1.1% vs 2.3%) in group A than in group B, respectively. There were no differences between both groups as regards the occurrence of pre-eclampsia, placental abruption, caesarean delivery, intra-partum bleeding or ecchymosis at operative wounds. There were no differences in most of the neonatal values between both groups. However, the mean birth weight was significantly higher in group A. LMWH seems to be a safe drug and effective in significantly reducing the incidence of recurrent miscarriages of unknown aetiology when given in the first trimester and continued throughout pregnancy.

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OBJECTIVE: To present our 15 years' experience in the management of 67 pregnancies in renal allograft recipients in Egypt. METHODS: A retrospective study of 67 pregnancies that occurred in 41 renal allograft recipients over the last 15 years. The study was performed in Department of Obstetrics & Gynecology, and Nephrology & Urology Center at Mansoura University, Egypt. RESULTS: Gestational diabetes occurred in 5.7%, infection in 13.4% and proteinuric hypertension in 19.2% of pregnancies. Graft dysfunction and obstructive uropathy occurred in 30.7% and 9.6% of pregnancies, respectively, but no episodes of graft rejection were reported. Pre-term labour was found in 40.9% and fetal growth retardation occurred in 19.2% of pregnancies. Perinatal mortality was in the order of 9.6%. Pregnancy outcome was better in non-cyclosporine group, in non-proteinuric hypertensive groups and in repeated pregnancies compared to the counter groups. CONCLUSION: Although pregnancy in renal transplant recipients is high-risk, successful outcome is expected for singleton pregnancy and is even better with repeated pregnancies in those cases with stable and good graft function. This satisfactory outcome is generally achieved if the graft is stable and the post-transplant interval is more than 2 years.

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Long-term follow up is required for early diagnosis of transformation of endometrial hyperplasia into malignancy. Transvaginal colour Doppler ultrasonography is a sensitive, specific and relatively non-invasive method of follow up.

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Fetal-pelvic index can be a sensitive and specific predictor of feto-pelvic disproportion. This can be of value when contemplating vaginal breech delivery.

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OBJECTIVE: To determine the effect of occupational physical activities on the outcome of pregnancy. METHODS: A case control study included two groups; the first one included 562 patients with spontaneous abortion as a case group, while the second one included 1200 ladies with full term deliveries as a matched control group. Occupational physical activity has been evaluated through the energy expenditure (fatigue score and intensity score) and the biomechanic load (abdominal pressure intensity score, relative chronic pressure and peak pressure scores) in both groups. RESULTS: The group of spontaneous abortion had a significant higher intensity score, fatigue score, unfavourable working hours and high working speed than the group of favourable pregnancy outcome. The study showed a significantly higher biomechanic load among the group of spontaneous abortion represented by higher peak pressure score, chronic pressure score, lifting and bending activities. The group of spontaneous abortion had a significant (P<0.05) higher housekeeping working hours per day than that of the control group. Also they had a significant larger family size and had a significant lower helping in housekeeping activities than the group of favourable outcome. CONCLUSION: Excessive occupational physical activity has a definite detrimental effect on the outcome of pregnancy.

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This study on 408 pregnant women with heart disease tried to audit the management of these women in a well equipped highrisk pregnancy unit. The outcome was nearly comparable to that obtained in series where the management was done in cardiology units.

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Earlier work suggested that high levels of CA125 could be detected in the sera of women with threatened abortion. In this study, we used CA125 as a method of anticipating outcome in cases of threatened abortion and compared the results with ultrasonic findings. Three groups of patients were studied.(1) 57 women who threatened to abort, but whose pregnancy continued.(2) 43 women with a threatened abortion, who subsequently aborted, and (3) 50 normal women who had no bleeding in early pregnancy. There was a highly significant increase in serum CA125 in women who aborted compared with the other two groups (P<0.001). The results compared well with conventional ultrasound and serum CA125 may be developed as a cheap, sensitive and specific predictor of outcome in cases of threatened abortion.

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Hepatitis-B surface antigen (HBsAg), circulating anti-schistosomal IgG (CSAb) and circulating specific schistosomal immune complexes (CIC) were detected, using ELISA, in sera of 40 active nephrotic children, 40 active S. mansoni infected cases and 20 apparently normal age-matched controls. The presence of HBsAg cases was significantly higher among nephrotic cases (20%), active S. mansoni cases (17.5%) than controls. Moreover, HBsAg cases were significantly higher in positive CIC S. mansoni cases than negative CIC ones. The mean O.D. readings of CSAb was significantly higher in positive HBsAg nephrotic cases than negatives. At the same time, the anti-schistosomal antibodies were higher in S. mansoni cases with proteinuria than those without. Specific CIC level was significantly higher among nephrotic and schistosomiasis cases than controls. The CIC were significantly higher in schistosomiasis cases with positive HBsAg than those with negative HBsAg and were detected in 80% of cases with proteinuria compared to 37% of cases without proteinuria with a statistically significant difference. On the other hand, CIC level was not influenced, in nephrotic cases, by the presence or absence of HBsAg. It was concluded that the presence of proteinuria was considered as a good monitor of the kidney affection either with schistosomiasis or the nephrotic syndrome or the HBsAg. The detection of CIC can be used as a good monitor too and could be included in methods of early diagnosis and/or following the disease prognosis.

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