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Article
ROLE OF DNA INTEGRITY OF SPERMATOZOA IN MALE INFERTILITY

Author: Ali F Al-Hashimi علي فؤاد الهاشمي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 1 Pages: 4-11
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background Classical semen analysis gives an approximate evaluation of the functional competence of spermatozoa, but not the quality of sperm DNA. With the advent of assisted reproductive technologies (ART), the concern over using damaged DNA has become apparent.Objective To clarify the role of DNA integrity and maturity of ejaculated spermatozoa in male infertility.MethodsA randomly selected group of 50 nonazoospermic infertile patients with a history of infertility of at least 1 year duration were included in this study. Whereas control group consisted of semen samples obtained from healthy volunteers of proven fertility (n = 27). Two main assays were studied in ejaculated spermatozoa: The green Acridine Orange (AO) fluorescence test that measures DNA integrity and the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-nick end labeling (TUNEL)- based ApopTag® technology that assesses DNA fragmentation as a late apoptotic marker. Results were compared with the standard sperm characteristics (concentration, motility and morphology) between infertile patients as well as some patients' subgroups against control donors.Results Significant low levels of green AO fluorescent spermatozoa were observed in all patients and patient's subgroups with asthenoteratozoospermia and oligoasthenoteratozoospermia (P = 0.00001). High percentages of TUNEL-positive spermatozoa were significantly noticed, against control donors, in all patients as well as asthenoteratozoospermic and oligoasthenoteratozoo-spermic infertile patients. Interestingly, normozoospermic patients had a significantly low percentage of green AO fluorescent spermatozoa and high levels of TUNEL-positive spermatozoa versus control donors (P = 0.0005, P = 0.0069, respectively).Conclusion From this study, it can be concluded that male infertility is associated with high rates of DNA damage in the spermatozoa, and that sperm DNA damage analysis could reveal a buried deformity of sperm nuclear DNA in infertile men classified as idiopathic, having apparently normal standard sperm parameters.Keywords DNA denaturation, DNA fragmentation, acridine orange, TUNEL.


Article
4.MOTOR EVOKED POTENTIAL IN PATIENTS WITH PARKINSON’S DISEASE: A TRANSCRANIAL MAGNETIC STIMULATION STUDY

Authors: Ali F. Al-Hashimi علي فؤاد الهاشمي --- Haneen R. Ahmed حنين رباح احمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 1 Pages: 14-21
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Parkinson’s disease (PD) is a neurodegenerative condition of the central nervous system, which is accompanied by the impairment of the cortico-subcortical excitation and inhibition systems. It is characterized by motor and non-motor symptoms, having both hypokinetic and hyperkinetic features.Objective:To investigate the integrity of the central motor pathways by studying the motor evoked potential (MEP) latencies, amplitudes and central conduction time (CMCT) of the median nerve in patients with PD as compared to healthy controls.Methods:Twenty-five patients with documented PD were studied; with a mean age of (63.16±5.49 years) as compared to 25 age and sex matched apparently healthy controls. All subjects were instructed about the examination and informed consent was provided. Transcranial magnetic stimulation TMS-MEP study of the right median nerve was done. Cortical and cervical latencies and amplitudes of the MEP study were determined. The responses were recorded with both relaxed and slightly contracted target muscle. CMCT calculation was done by subtraction of the latency of peripheral segment of the motor pathway (spinal motor root to muscle) from that of the entire motor pathway (motor cortex to muscle) or by calculation of the CMCT with the F-wave method. Results:The means of the cortical latencies of PD patients during relaxation and facilitation states were lower than controls; and the differences were significant for both (P=0.03 and 0.02; respectively). In both relaxed and facilitation states, the means of CMCT in PD patients were lower than in control and the difference was significant during contraction (P=0.02), and near statistical significance during relaxation (P=0.08). CMCT calculations by the estimation of F wave and distal motor latency (DML) were equivocal between relaxation and facilitation states. Nevertheless, the differences were not statistically significant (P=0.45; P=0.62; respectively). The means of the MEP amplitude of PD patients were lower than controls (4.21±1.94 versus 4.28± 1.84 mV; respectively). Nevertheless, the differences were not significant (P=0.89).Conclusion:Single-pulse TMS is a valuable study to investigate central motor dysfunction in PD. CMCT measurement of the median nerve or any nerve in the upper limb is a potential marker for the evaluation of the severity of PD; especially in the facilitated state.Keywords:Parkinson’s disease, TMS, MEP, CL, CMCTCitation:Ahmed HR, Al-Hashimi AF. Motor evoked potential in patients with Parkinson’s Disease: a transcranial magnetic stimulation study. Iraqi JMS. 2018; Vol. 16(1): 14-21. doi: 10.22578/IJMS.16.1.4

Keywords

Parkinson’s disease --- TMS --- MEP --- CL --- CMCT


Article
THE VALUE OF MIXED SOMATOSENSORY EVOKED POTENTIAL IN THE DIAGNOSIS OF LUMBOSACRAL SPINAL CANAL STENOSIS

Authors: Zainab M. Essa زينب محمد تقي عيسى --- Ali F. Al-Hashimi علي فؤاد الهاشمي --- Ihssan S. Nema احسان صبحي نعمه
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2015 Volume: 13 Issue: 3 Pages: 219-226
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Lumbosacral spinal canal stenosis is a common cause for chronic low back pain. The diagnosis is mostly radiological, yet, the extent of neural impairment cannot be expressed by radiological means. It is hypothesized that somatosensory evoked potential indicate a nerve root involvement complementary to the neurological examination.Objectives:To evaluate the usefulness of different parameters of mixed somatosensory evoked potential in the diagnosis of lumbosacral stenosis.Methods:Thirty five patients with Lumbosacral stenosis, clinically and radiologically confirmed by MRI examination and 20 normal individuals were enrolled in the study. Mixed-somatosensory evoked potentials of tibial nerve was done using subdermal monopolar needle electrodes at 4 channels; cortical, lower thoracic, lumbar and popliteal. From these channels negative waves (N45, N25, N20 and N10) were studied for both latency and amplitude, besides the central sensory conduction time which represents inter-peak latency between N25 and N45.Results:The cutoff values of N25, N45 and N20 wave latencies presented highly significant differences between affected sides and controls; with the highest difference given by N25 wave (P< 0.0001). There was no significant difference regarding N10 and N25-N45 latencies. The mixed somatosensory wave amplitude cutoff values showed equivocal results about the sensitivity and specificity percentages.Conclusions:Mixed somatosensory evoked potential study can be used as a supplementary test in the diagnosis of Lumbosacral stenosis. N25 wave has the highest diagnostic yield due to having the highest sensitivity and specificity. Equivocal results of the evoked potential amplitudes and their lower sensitivities and specificities compared to evoked potential latencies, lower their validity in the diagnosis of Lumbosacral spinal stenosis.Keyword:Cutoff, sensitivity, specificity, referred.

Keywords

Cutoff --- sensitivity --- specificity --- referred

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