EVALUATION OF VITAMIN D SERUM LEVELS AND THYROID FUNCTION TEST IN HYPOTHYROIDISM IRAQI PATIENTS

The role of Vitamin D is primarily to maintain calcium and phosphate levels in the bloodstream. Significantly, steroid hormone receptors are the binding sites for both vitamin D and thyroid hormone. However, the vitamin D and thyroid function relationship is still not fully understood. The study aims to measure vitamin D serum levels and to investigate its relation with hypothyroidism in Iraq patients.This case-control study was carried out during the period from the first of March to the end of May 2023 in Baghdad City, Iraq. The study included 90 subjects that were divided into 2 groups. The first group consists of 60 people infected with hypothyroidism. The second group (control group) consists of 30 healthy people. Blood samples were assessed for serum vitamin D, TSH, T3 and T4 using a chemiluminescence microparticle immunoassay analyzer while serum anti-TPO used an enzyme-linked immunosorbent assay technique.The study showed that the level of T3, T4 and vitamin D in hypothyroidism patients significantly decreased compared to the control group (p<0.001). While TSH and anti-TPO levels in hypothyroidism patients significantly increase in comparison to the control group (p<0.001). The study found a significant negative correlation between (vitamin D and T3) with (p<0.01), while the study showed a significant positive correlation between (TSH and vitamin D) with (p<0.01). Finally, the study demonstrated a non-significant weak negative correlation (p>0.05) between (vitamin D and T4), but a non-significant weak positive correlation (p>0.05) between (vitamin D and anti-TPO).Patients with hypothyroidism had noticeably low levels of vitamin D, indicating that this vitamin D may be involved in the aetiology of hypothyroidism.

TESTOSTERONE AND SERUM ZINC LEVELS IN MEN WITH BENIGN PROSTATIC HYPERPLASIA

Benign prostatic hyperplasia (BPH) is a common benign tumour of the prostate that becomes more common as men age. The purpose of this study is to investigate the relationships between serum zinc and testosterone in BPH patients in Iraq. This case-control study entailed gathering 90 subjects which were separated into two groups, group A consisted of 60 patients with benign prostatic hyperplasia, while group B consisted of 30 healthy males. Diagnosis revealed patient's prostate volumes (PV) were equal to or more than 25 millilitres. Both groups had their serum zinc and serum testosterone levels. The study showed that the mean prostate size was elevated significantly in the BPH group (54.0±8.4cc) as compared with the control group (19.66±2.88cc) (P:0.01). There is a significant reduction in the serum testosterone concentration of benign prostatic hyperplasia patients, (4.05±3.1 ng/ml), as compared with control subjects, (11.37±2.87; p≤0.01). There is a significant reduction in the serum zinc concentration of benign prostatic hyperplasia patients, (70.4±9.63 ng/ml), as compared with control subjects, (99.3±10.5; p≤0.01). The higher percentage of benign prostatic hyperplasia is in patients above 66 years, and the lowest is in the age group 45-55 years. Serum testosterone and zinc are significantly lower in benign prostatic hyperplasia patients than in age-matched healthy controls. All benign prostatic hyperplasia patients have larger prostates than normal healthy control participants of the same BMI. All BMI groups of benign prostatic hyperplasia patients had lower serum testosterone and zinc than normal healthy control persons of the same BMI.

THE ROLE OF MELATONIN AND VITAMIN D IN IRAQI PREMENOPAUSAL WOMEN OSTEOARTHRITIS PATIENTS

Osteoarthritis (OA) is the most common form of arthritis, affecting 1 in 3 people over age 40 and women more so than men. The prevalence of OA is rising due to the increasing prevalence of OA risk factors, including obesity, physical inactivity, and joint injury. The aim of the study is to determine the correlation of Melatonin, Vitamin D (VitD) with osteoarthritis (OA) in women premenopausal OA women in age between 40-50 years old. The study included 60 patients with OA and 30 patients without OA from the general Balad Hospital in Salah Al-Den governorates. All subjects were premenopausal women between 40-50 years old. OA was diagnosed according to the clinical examination, X-ray diagnosis by Bone mineral density testing using STRATOS device, and biochemical tests using ELISA and COBOS 6000. This study proved that Melatonin is correlated with osteoarthritis in premenopausal women, there is a significant decrease (P≤0.01) in Melatonin (1.308+0.20 pg/dl), Vitamin D (22.82+1.53) mg/ml. Melatonin was positively correlated with vitamin D with no correlation with other biomarkers. Osteoarthritis in premenopausal women is strongly affected by Melatonin levels and Vitamin D, and it's recommended to use Melatonin and other chemical parameters as markers and potential therapeutic drugs.

Bacterial vaginosis, vulvovaginal candidiasis and trichomonal vaginitis among reproductive-aged women seeking primary healthcare in Sana'a city, Yemen

BACKGROUND

In Yemen, the underlying causes of infectious vaginitis have been neglected. Therefore, this study aimed to determine the prevalence and risk factors associated with bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonal vaginitis (TV) among non-pregnant reproductive-aged women.

METHODS

A cross-sectional study was conducted among 347 non-pregnant reproductive-aged women seeking primary healthcare in Sana'a city, Yemen. Data about sociodemographic characteristics, lifestyle-related behaviors, routine hygienic practices, menstrual care and history and type of contraceptive intake were collected using a structured questionnaire. Vaginal discharge samples were collected and examined for discharge characteristics and pH by a gynecologist. Then, samples were examined for BV, VVC and TV. Data were analyzed using suitable statistical tests.

RESULTS

Vaginal infections were prevalent among 37.6% of reproductive-aged women, where BV was the most prevalent (27.2%). VVC was significantly higher among symptomatic women and significantly associated with itching (P = 0.005). Using bivariate analysis, the age of < 25 years (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.16-3.10; P = 0.010) and using intrauterine contraceptive devices (IUCDs) (OR = 1.8, 95% CI: 1.09-2.89; P = 0.020) were significantly associated with BV, while history of miscarriage was significantly associated with a lower risk of BV (OR = 0.5, 95% CI: 0.31-0.85, P = 0.009). However, polygyny was significantly associated with VVC (OR = 3.4, 95% CI: 1.33-8.66; P = 0.007). Multivariable analysis confirmed that age of < 25 years and using IUCD were the independent predictors of BV, while history of miscarriage was an independent protective factor against BV. On the other hand, marriage to a polygamous husband was the independent predictor of VVC.

CONCLUSIONS

More than a third of non-pregnant reproductive-aged women seeking PHC in Sana'a have single or mixed infections with BV, VVC or TV. BV is the most frequent cause of vaginitis and is significantly associated with the age of < 25 years and using IUCDs, while VVC is significantly higher among women with polygamous husbands. Health education of polygamous husbands and their wives, regular monitoring of BV among IUCD users and screening women for vaginitis before treatment are recommended.

Intracytoplasmic sperm injection for treatment of infertility due to acrosomal enzyme deficiency

OBJECTIVE

To determine whether absence of fertilization in IVF associated with an acrosomal enzyme defect (hyaluronidase deficiency) results from a simple mechanical block to sperm penetration or from a more serious sperm abnormality.

DESIGN

Nonrandomized, prospective study.

SETTING

Toronto Center for Advanced Reproductive Technology, a tertiary referral center for infertility associated with The University of Toronto.

PATIENTS

One hundred twenty-two couples about to undergo intracytoplasmic sperm injection (ICSI) were selected. Thirty-six of the studied couples had failed to fertilize in prior IVF cycles.

INTERVENTIONS

Hyaluronidase activity was measured in the semen samples provided for ICSI using a zymogenic assay. Intracytoplasmic sperm injection was performed in all couples using standard techniques.

RESULTS

Forty-eight of 122 semen samples had poor of absent semen hyaluronidase activity. All 48 samples resulted in successful fertilization with ICSI in the present study. The average fertilization rate per oocyte was 59.43% in couples in whom the partner had low semen hyaluronidase activity and 55.85% in whom the male had normal hyaluronidase activity. The ET rate per cycle was 100% and 95% and pregnancy rates per cycles were 26% and 25% in cycles with poor and normal semen hyaluronidase activity, respectively. Unlike routine IVF, no statistical correlation was found between semen hyaluronidase activity and the fertilization rate in ICSI.

CONCLUSION

Our results indicates that semen hyaluronidase deficiency is associated with a simple mechanical block to fertilization. In addition, the measurement of semen hyaluronidase activity can provide a reliable means for selecting couples who would benefit from ICSI.

Hyaluronidase activity in human semen: correlation with fertilization in vitro

OBJECTIVES

To characterize the relationship between hyaluronidase activity and the currently used methods of assessing sperm function and to determine whether the measurement of hyaluronidase activity can provide a reliable index of sperm fertilizing capacity in man.

DESIGN

Nonrandomized prospective study.

SETTING

Tertiary referral IVF and andrology clinics affiliated with the University of Toronto.

SUBJECTS

Four hundred eight samples were collected, 248 from men undergoing investigation in andrology and fertility clinics and 160 from men participating in an IVF program.

INTERVENTIONS

Semen samples were treated with NP-40 in buffer to extract hyaluronidase and applied to a circular well cut into a petri dish containing a mixture of hyaluronic acid and agar. Enzyme activity was assessed by measuring the area of substrate hydrolysis.

RESULTS

Significant positive correlations were found between hyaluronidase activity and sperm concentration, motility, and the percentage of sperm with normal morphology in the studied samples. In the IVF samples, hyaluronidase activity was found to be related significantly to the fertilization rate. Moreover, we were able to establish values of hyaluronidase below which no fertilization occurred and above which fertilization of at least one oocyte was achieved.

CONCLUSION

These results suggest that measurement of hyaluronidase activity may provide a useful method for assessing the integrity of the acrosomal enzyme system, providing a simple and reliable predictor of the fertilizing potential of human sperm.