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Brahmbhatt N, Mishra V, Aggrawal R, Chaudhary S, Shah K, Priya P, Solanki S, Sheth H, Patel K, Suthar A, Patel K, Repswal P, Dongare A. P-059 Effect of outcome of microfluidic sperm sorter and conventional swim-up technique on DNA integrity of the sperm. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does the approach of sperm preparation technique plays any role in sperm DNA Integrity
Summary answer
Outcome of the semen sample is directly proportional to the choice of preparation technique. Microfluidics improves sperm selection and results in better sperm DNA integrity
What is known already
Microfluidic systems are promising tools for fluid manipulation that can noninvasively separate motile sperm with higher hydrodynamics profile from the lower ones. It also enables to manipulate micro swimmers as compared to the traditional methods that to without centrifugation .As it is already known that Semen analysis and preparation is one of the most important aspects in andrology and microfluidics can improve sperm analysis and selection, therefore increasing the ART success rates
Study design, size, duration
Comparative study from July 2019 to Dec 2021 in IVF unit of IKDRC Hospital .A total number of 900 patients were enrolled in the study and were randomized by using computer generated list then divided into two groups, Group A contains 460 samples and Group B having 440 samples.
Participants/materials, setting, methods
Group A (n = 460) sample was prepared by using Microfluidic sperm Sorting technique and Group B (n = 440) sample was prepared by conventional Swim up technique. Samples were analyzed according to WHO 2010 laboratory manual for examination and processing of human sperm, including all normozoospermic samples. Primary outcomes of the study was DNA Fragmentation index (DFI) and it was evaluated by using sperm chromatin dispersion (SCD) test and secondary outcomes was Progressive motility .
Main results and the role of chance
DNA fragmentation index is significantly lower in group A where Microfluidic Sperm Sorting technique (MFSS )is used than in group B where conventional swim up technique is use (10.06% vs 34.2%, p<0.0001) significant values implies that DNA integrity is better in group A than in group B and progressive motility was also found to be significantly higher in group A as compared to group B (57.6%vs16.9%, p <0.001).
Limitations, reasons for caution
As sample size was smaller, larger randomized control studies are needed to strengthen these results and all normal samples were used for the analysis and preparation , abnormal parameters were not involved .
Wider implications of the findings
According to our study the samples prepared by Microfluidic technique have higher DNA integrity than samples prepared by Swim up technique. Lower DNA Fragmentation index in microfluidics outcome indicates lower DNA damage. Choice of technique for the preparation of semen sample also plays a key role in better sperm selection.
Trial registration number
N/A
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Affiliation(s)
- N Brahmbhatt
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - V Mishra
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - R Aggrawal
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - S Chaudhary
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - K Shah
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - P Priya
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - S Solanki
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
| | - H Sheth
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - K Patel
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - A Suthar
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - K Patel
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - P Repswal
- IVF Unit -Department of obs and gynae , Embryology, ahemdabad, India
| | - A Dongare
- IVF Unit -Department of obs and gynae, obstetrics and gynaecology , ahemdabad, India
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Sirimaturos M, Gotur DB, Patel SJ, Dreucean D, Jakowenko N, Cooper MH, Brahmbhatt N, Graviss EA, Nguyen DT, Pingali SR, Lin J, Musick WL. Clinical Outcomes Following Tocilizumab Administration in Mechanically Ventilated Coronavirus Disease 2019 Patients. Crit Care Explor 2020; 2:e0232. [PMID: 33063035 PMCID: PMC7531754 DOI: 10.1097/cce.0000000000000232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Effective treatments for the critically ill patient with novel coronavirus disease 2019 are desperately needed. Given the role of cytokine release syndrome in the pathogenesis of coronavirus disease 2019-associated respiratory distress, therapies aimed at mitigating cytokine release, such as the interleukin-6 receptor-inhibiting monoclonal antibody tocilizumab, represent potential treatment strategies. Therefore, we examined the outcomes of critically ill coronavirus disease 2019 patients treated with tocilizumab and factors associated with clinical improvement. DESIGN A retrospective cohort analysis of 21-day outcomes for consecutive mechanically ventilated patients treated with tocilizumab from March 24, 2020, to May 4, 2020. SETTING Nine ICUs at six hospitals within a hospital system in Houston, Texas, United States. PATIENTS The first 62 coronavirus disease 2019 patients on invasive mechanical ventilation who were treated with tocilizumab, which was considered for all patients with severe disease. INTERVENTIONS Tocilizumab was administered either at a weight-based dose of 4-8 mg/kg or at a flat dose of 400 mg, with repeat administration in some patients at the physician's discretion. MEASUREMENTS AND MAIN RESULTS The primary outcomes were mortality and clinical improvement, defined as extubation. By day 21 post-tocilizumab, clinical improvement occurred in 36 patients (58%) and 13 patients (21%) died. In both univariable and multivariable analyses, age less than 60 years was associated with clinical improvement. Transient transaminitis was the most common adverse reaction, occurring in 25 patients (40%). CONCLUSIONS Based on clinical outcomes and mortality rates seen in previous reports of mechanically ventilated patients, tocilizumab, as part of the management strategy for severe coronavirus disease 2019, represents a promising option. These findings support the need for evaluation of tocilizumab in a randomized controlled trial.
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Affiliation(s)
| | | | - Samir J Patel
- Department of Pharmacy, Houston Methodist Hospital, Houston, TX
| | - Diane Dreucean
- Department of Pharmacy, Houston Methodist Hospital, Houston, TX
| | | | - Megan H Cooper
- Department of Pharmacy, Houston Methodist Hospital, Houston, TX
| | | | - Edward A Graviss
- Houston Methodist Academic Institute, Houston, TX
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
| | - Duc T Nguyen
- Houston Methodist Academic Institute, Houston, TX
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
| | - Sai Ravi Pingali
- Weill Cornell Medical College, New York, NY
- Houston Methodist Cancer Center, Houston, TX
| | - Jiejian Lin
- Infectious Diseases, Houston Methodist Hospital, Houston, TX
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Brahmbhatt N, Tamimi O, Ellison H, Katta S, Youssef J, Cortes C, Gotur D. Pneumatocele and cysts in a patient with severe acute respiratory syndrome coronavirus 2 infection. JTCVS Tech 2020; 4:353-355. [PMID: 32864633 PMCID: PMC7441992 DOI: 10.1016/j.xjtc.2020.08.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nishal Brahmbhatt
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Omar Tamimi
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Henry Ellison
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Sai Katta
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Jihad Youssef
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Christopher Cortes
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
| | - Deepa Gotur
- Department of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, Tex
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Benjamin B, Brahmbhatt N, Santacruz J, Mahesh R. Migratory breast implant: a case report and brief review. Southwest J Pulm Crit Care 2020. [DOI: 10.13175/swjpcc039-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Brahmbhatt N, Ikeda R, Devendra G. A Case of Tacrolimus-Associated Organizing Pneumonia (OP). Chest 2016. [DOI: 10.1016/j.chest.2016.08.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bhavsar NV, Trivedi SR, Dulani K, Brahmbhatt N, Shah S, Chaudhri D. Clinical and radiographic evaluation of effect of risedronate 5 mg as an adjunct to treatment of chronic periodontitis in postmenopausal women (12-month study). Osteoporos Int 2016; 27:2611-9. [PMID: 27026334 DOI: 10.1007/s00198-016-3577-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED Bisphosphonates are beneficial to women, after menopause, in treatment of gum diseases. In this study, significant improvement in the disease condition was found and that no further progress was noted, and no side effects were reported. Bisphosphonates can be safely and successfully be used to support oral health procedures. INTRODUCTION The purpose of this study was to evaluate host modulating effect of bisphosphonate adjunct with the treatment of chronic periodontitis in osteopenic and osteoporotic postmenopausal women. METHODS Twenty-two osteopenic and osteoporotic postmenopausal women with moderate to severe chronic periodontitis were selected for the study. On intraoral examination, periodontal parameters like probing depth (PD), clinical attachment level (CAL), Plaque Index (PI) and Gingival Index (GI) were recorded. Scaling and root planing were done. Intraoral periapical X-rays were taken, and alveolar bone density (ABD) was measured with cone beam computed tomography (CBCT), and then, medications (risedronate 5 mg once daily (OD), calcium citrate 250 mg OD, vitamin D 400 IU OD) were given. Patients were recalled for follow-up at 3, 6 and 12 months. Intraoral periapical (IOPA) X-rays were taken at 6 and 12 months and ABD was measured at baseline and 12 months. RESULTS There was a significant improvement in all the parameters. There was an increase of 0.02 ± 0.001 cm on CT scan and 0.38 ± 0.005 mm on IOPA in bone height over 12 months from baseline. Bone density increased by 118.56 ± 3.251 Hounsfield units (HU). There was no progress in the disease, and further bone loss was not noticed. This is in correlation with clinical parameters which showed highly significant gain in CAL (3.57 ± 0.234 mm) and reduction in PD (2.20 ± 0.229 mm) CONCLUSIONS Bisphosphonate therapy as an adjunct to scaling and root planing may have significant beneficial clinical effects on the periodontium of postmenopausal women with moderate to severe chronic periodontitis.
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Affiliation(s)
- N V Bhavsar
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India.
| | - S R Trivedi
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - K Dulani
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - N Brahmbhatt
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - S Shah
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - D Chaudhri
- Department of Periodontology, Siddhpur Dental College, Siddhpur, Gujarat, India
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German JC, Worcester C, Gazzaniga AB, Huxtable RF, Amlie RN, Brahmbhatt N, Bartlett RH. Technical aspects in the management of the meconium aspiration syndrome with extracorporeal circulation. J Pediatr Surg 1980; 15:378-83. [PMID: 7411345 DOI: 10.1016/s0022-3468(80)80740-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Sixteen neonatal patients diagnosed as having the meconium aspiration syndrome were selected for management with extracorporeal circulation with a membrane oxygenator (ECMO) with 8 survivors over 4 yr. All patients weighed greater than 2 kg. Each was placed in the 100% mortality group according to a Neonatal Pulmonary Insufficiency Index (NPII) based on hourly pH and FiO2 determinations. The typical patient course on ECMO was stabilization for the first 12 hr then improvement on high bypass flow rates for 12-24 hr to maintain a pAO2 for 50-60 mm Hg with minimal ventilator settings with an FiO2 of 0.3-0.4. Bypass flow rates were reduced to maintain adequate pAO2 with similar ventilator settings for another 24 hr. Survivors were taken off bypass and decannulated while on similar ventilator settings. Nonsurvivors did stabilize or improve but usually exhibited symptoms of intracranial hemorrhage by 48 hr. Intracranial hemorrhage appeared to be related to the degree of prebypass acidosis. Successful ECMO support reduced the expected mortality from severe meconium aspiration from 100% to 50%. Early institution of ECMO, before acidosis worsens, seems to be indicated to reduce the morbidity of conventional ventilator management and to prevent intracranial hemorrhage from severe prebypass acidosis. Long term followup indicates that these patients have progressed satisfactorily according to developmental testing for as long as 4 yr.
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Abstract
Fifty-five patients were scored 1 to 3 according to the criteria: the character of stools, abdominal findings on palpation, x-ray evidence of pneumatosis intestinalis, the development of pulmonary insufficiency, and the duration of symptoms to positive x-rays. Fifteen patients with scores of less than five were considered to have subclinical NEC with one late death. Twenty-nine of 30 patients with scores of 5-10 responded to medical management with 2 deaths related to recurrent bouts of sepsis without recurrent NEC. Eleven patients required surgery with index scores of 10-14 with 6 deaths occurring uniformly in those patients with scores of 12 or more. Two patients were scored inappropriately low due to the lack of the passage of a stool for analysis. One patient with a score of 4 did not pass a stool but had the other diagnostic criteria for the single false negative of the series. This index correctly determined the severity of NEC of 53 of 55 patients, identified the patients who required surgical intervention and predicted survival.
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MESH Headings
- Enterocolitis, Pseudomembranous/diagnosis
- Enterocolitis, Pseudomembranous/surgery
- Enterocolitis, Pseudomembranous/therapy
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/surgery
- Infant, Newborn, Diseases/therapy
- Male
- Retrospective Studies
- Risk
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