Displaying publications 1 - 20 of 37 in total

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  1. Upregulation of insulin secretion and downregulation of pro-inflammatory cytokines, oxidative stress and hyperglycemia in STZ-nicotinamide-induced type 2 diabetic rats by Pseuduvaria monticola bark extract
    Taha H, Arya A, Paydar M, Looi CY, Wong WF, Vasudeva Murthy CR, et al.
    Food Chem Toxicol, 2014 Apr;66:295-306.
    PMID: 24518542 DOI: 10.1016/j.fct.2014.01.054
    The current study aimed to ascertain the antidiabetic potential of Pseuduvaria monticola bark methanolic extract (PMm) using in vitro mechanistic study models. In particular, the study determined the effect of PMm on cellular viability, 2-NBDG glucose uptake, insulin secretion, and NF-κB translocation in mouse pancreatic insulinoma cells (NIT-1). Furthermore, in vivo acute toxicity and antidiabetic studies were performed using streptozotocin (STZ)-induced type 1 and STZ-nicotinamide-induced type 2 diabetic rat models to evaluate various biochemical parameters and markers of oxidative stress and pro-inflammatory cytokines. Five isoquinoline alkaloids and three phenolic compounds were tentatively identified in the PMm by LC/MS Triple TOF. The study results showed that PMm is non-toxic to NIT-1 cells and significantly increased the glucose uptake and insulin secretion without affecting the translocation of NF-κB. Moreover, the non-toxic effects of PMm were confirmed through an in vivo acute toxicity study, which revealed that the serum insulin and C-peptide levels were significantly upregulated in type 2 diabetic rats and that no significant changes were observed in type 1 diabetic rats. Similarly, PMm was found to downregulate the levels of oxidative stress and pro-inflammatory cytokines in type 2 diabetic rats by alleviating hyperglycemia. Therefore, we conclude that PMm may be developed as an antidiabetic agent for the treatment of type 2 diabetes-associated conditions.
  2. The monitoring of pesticides and alkylphenols in selected rivers in the State of Selangor, Malaysia
    Tan BL, Mustafa AM
    Asia Pac J Public Health, 2004;16(1):54-63.
    PMID: 18839869
    Alkylphenols and most pesticides, especially organochlorine pesticides are endocrine-disrupting chemicals and they usually mimic the female hormone, estrogen. Using these chemicals in our environment would eventually lead us to consume them somehow in the food web. Several rivers in the State of Selangor, Malaysia were selected to monitor the level of alkylphenols and pesticides contamination for several months. The compounds were extracted from the water samples using liquid-liquid extraction method with dichloromethane and ethyl acetate as the extracting solvents. The alkylphenols and pesticides were analyzed by selected ion monitoring (SIM) mode using the quadrapole detector in Shimadzu QP-5000 gas chromatograph-mass spectrometer (GCMS). Recovery of most alkylphenols and pesticides were in the range of 50% to 120%. Trace amounts of the compounds were detected in the river water samples, mainly in the range of parts per trillion. This technique of monitoring the levels of endocrine-disruptors in river water is consistent and cost effective.
  3. The carrying angle: racial differences and relevance to inter-epicondylar distance of the humerus
    Allouh MZ, Abu Ghaida JH, Jarrar AA, Khasawneh RR, Mustafa AG, Bashaireh KM
    Folia Morphol (Warsz), 2016 02 26;75(3):388-392.
    PMID: 26916201 DOI: 10.5603/FM.a2016.0007
    The human carrying angle (CA) is a measure of the lateral deflection of the forearm from the arm. The importance of this angle emerges from its functional and clinical relevance. Previous studies have correlated this angle with different parameters including age, gender, and handedness. However, no reports have focused on race-dependent variations in CA or its relation to various components of the elbow joint. This study aimed to investigate the variations in CA with respect to race and inter-epicondylar distance (IED) of the humerus. The study included 457 Jordanian and 345 Malaysian volunteers with an age range of 18-21 years. All participants were right-hand dominant with no previous medical history in their upper limbs. Both CA and IED were measured by well-trained medical practitioners according to a well-established protocol. Regardless of race, CA was greater on the dominant side and in females. Furthermore, CA was significantly greater in Malaysian males compared to Jordanian males, and significantly smaller in Malaysian females compared to their Jordanian counterparts. Finally, CA significantly decreased with increasing IED in both races. This study supports effects of gender and handedness on the CA independent of race. However, CA also varies with race, and this variation is independent of age, gender, and handedness. The evaluation also revealed an inverse relationship between CA and IED. These findings indicate that multiple factors including race and IED should be considered during the examination and management of elbow fractures and epicondylar diseases.
  4. Fulltext Stochastic frontier model approach for measuring stock market efficiency with different distributions
    Hasan MZ, Kamil AA, Mustafa A, Baten MA
    PLoS One, 2012;7(5):e37047.
    PMID: 22629352 DOI: 10.1371/journal.pone.0037047
    The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time-varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation.
  5. Fulltext Stochastic Frontier approach and Data Envelopment Analysis to Total Factor Productivity and efficiency measurement of Bangladeshi rice
    Hossain MK, Kamil AA, Baten MA, Mustafa A
    PLoS One, 2012;7(10):e46081.
    PMID: 23077500 DOI: 10.1371/journal.pone.0046081
    The objective of this paper is to apply the Translog Stochastic Frontier production model (SFA) and Data Envelopment Analysis (DEA) to estimate efficiencies over time and the Total Factor Productivity (TFP) growth rate for Bangladeshi rice crops (Aus, Aman and Boro) throughout the most recent data available comprising the period 1989-2008. Results indicate that technical efficiency was observed as higher for Boro among the three types of rice, but the overall technical efficiency of rice production was found around 50%. Although positive changes exist in TFP for the sample analyzed, the average growth rate of TFP for rice production was estimated at almost the same levels for both Translog SFA with half normal distribution and DEA. Estimated TFP from SFA is forecasted with ARIMA (2, 0, 0) model. ARIMA (1, 0, 0) model is used to forecast TFP of Aman from DEA estimation.
  6. Simultaneous determination of organochlorine pesticides and bisphenol A in edible marine biota by GC-MS
    Santhi VA, Hairin T, Mustafa AM
    Chemosphere, 2012 Mar;86(10):1066-71.
    PMID: 22197311 DOI: 10.1016/j.chemosphere.2011.11.063
    A study to assess the level of organochlorine pesticides (OCPs) and bisphenol A (BPA) in edible marine biota collected from coastal waters of Malaysia was conducted using GC-MS and SPE extraction. An analytical method was developed and validated to measure the level of 15 OCPs and BPA simultaneously from five selected marine species. It was observed that some samples had low levels of p,p'-DDE, p,p'-DDT and p,p'- DDD ranging from 0.50 ng g(-1) to 22.49 ng g(-1) dry weight (d.w) but significantly elevated level of endosulfan I was detected in a stingray sample at 2880 ng g(-1) d.w. BPA was detected in 31 out of 57 samples with concentration ranging from below quantification level (LOQ: 3 ng g(-1)) to 729 ng g(-1) d.w. The presence of OCPs is most likely from past use although there is also indication of illegal use in recent times. The study also reveals that BPA is more widely distributed in coastal species caught off the coast of the most developed state. The potential health risk from dietary intakes of OCPs and BPA from the analysed fish species was negligible.
  7. Fulltext Serum Eosinophilic Cationic Protein (ECP) in Asthmatic Malaysian Children
    Chan PWK, Samsinah HH, Arpin HZ, Mustafa AM, de Bruyne JA
    Med J Malaysia, 2002 Jun;57(2):201-4.
    PMID: 24326651
    Eosinophilic inflammation in the airways is important in the pathogenesis of childhood asthma. Serum eosinophilic cationic protein (ECP), a marker of eosinophil activation was measured in 20 asthmatic children and 19 non-asthmatic controls. There was no difference in the socio-demography, passive smoke exposure, urinary cotinine levels and family history of asthma between the 2 groups. The median serum ECP in asthmatic children was 27.0 mcg/L (IQ1 8.8, IQ3 59.0); which was higher than in non-asthmatic controls [5.9 mcg/L (IQ1 3.0, IQ3 11.9), p=0.002]. An elevated serum ECP level can be helpful as supportive evidence in the diagnosis of bronchial asthma in Malaysia children.
  8. Revisiting Wallace's haunt: coalescent simulations and comparative niche modeling reveal historical mechanisms that promoted avian population divergence in the Malay Archipelago
    Lim HC, Rahman MA, Lim SL, Moyle RG, Sheldon FH
    Evolution, 2011 Feb;65(2):321-34.
    PMID: 20796023 DOI: 10.1111/j.1558-5646.2010.01105.x
    Sundaland, a biogeographic region of Southeast Asia, is a major biodiversity hotspot. However, little is known about the relative importance of Pleistocene habitat barriers and rivers in structuring populations and promoting diversification here. We sampled 16 lowland rainforest bird species primarily from peninsular Malaysia and Borneo to test the long-standing hypothesis that animals on different Sundaic landmasses intermixed extensively when lower sea-levels during the Last Glacial Maximum (LGM) exposed land-bridges. This hypothesis was rejected in all but five species through coalescent simulations. Furthermore, we detected a range of phylogeographic patterns; Bornean populations are often genetically distinct from each other, despite their current habitat connectivity. Environmental niche modeling showed that the presence of unsuitable habitats between western and eastern Sundaland during the LGM coincided with deeper interpopulation genetic divergences. The location of this habitat barrier had been hypothesized previously based on other evidence. Paleo-riverine barriers are unlikely to have produced such a pattern, but we cannot rule out that they acted with habitat changes to impede population exchanges across the Sunda shelf. The distinctiveness of northeastern Borneo populations may be underlied by a combination of factors such as rivers, LGM expansion of montane forests and other aspects of regional physiography.
  9. Phytoestrogens levels determination in the cord blood from Malaysia rural and urban populations
    Mustafa AM, Malintan NT, Seelan S, Zhan Z, Mohamed Z, Hassan J, et al.
    Toxicol Appl Pharmacol, 2007 Jul 1;222(1):25-32.
    PMID: 17490695
    This study is a result of an analysis of free and conjugated phytoestrogens daidzein, genistein, daidzin, genistin and coumesterol in human cord blood plasma using LCMS. Cord blood was collected from urban and rural populations of Malaysia (n=300) to establish a simple preliminary database on the levels of the analyzed compounds in the collected samples. The study also aimed to look at the levels of phytoestrogens in babies during birth as this may have a profound effect on the developmental process. The sample clean up was carried out by solid-phase extraction using C18 column and passed through DEAE sephadex gel before analysis by LCMS. The mean concentrations of total phytoestrogens were daidzein (1.4+/-2.9 ng/ml), genistein (3.7+/-2.8 ng/ml), daidzin (3.5+/-3.1 ng/ml), genistin (19.5+/-4.2 ng/ml) and coumesterol (3.3+/-3.3 ng/ml). Distribution of phytoestrogen was found to be higher in samples collected from rural areas compared to that of urban areas.
  10. Fulltext Palladium/Graphene Oxide Nanocomposite for Hydrogen Gas Sensing Applications Based on Tapered Optical Fiber
    Alkhabet MM, Yaseen ZM, Eldirderi MMA, Khedher KM, Jawad AH, Girei SH, et al.
    Materials (Basel), 2022 Nov 17;15(22).
    PMID: 36431654 DOI: 10.3390/ma15228167
    Gaseous pollutants such as hydrogen gas (H2) are emitted in daily human activities. They have been massively studied owing to their high explosivity and widespread usage in many domains. The current research is designed to analyse optical fiber-based H2 gas sensors by incorporating palladium/graphene oxide (Pd/GO) nanocomposite coating as sensing layers. The fabricated multimode silica fiber (MMF) sensors were used as a transducing platform. The tapering process is essential to improve the sensitivity to the environment through the interaction of the evanescent field over the area of the tapered surface area. Several characterization methods including FESEM, EDX, AFM, and XRD were adopted to examine the structure properties of the materials and achieve more understandable facts about their functional performance of the optical sensor. Characterisation results demonstrated structures with a higher surface for analyte gas reaction to the optical sensor performance. Results indicated an observed increment in the Pd/GO nanocomposite-based sensor responses subjected to the H2 concentrations increased from 0.125% to 2.00%. The achieved sensitivities were 33.22/vol% with a response time of 48 s and recovery time of 7 min. The developed optical fiber sensors achieved excellent selectivity and stability toward H2 gas upon exposure to other gases such as ammonia and methane.
  11. Occurrence of bisphenol A in surface water, drinking water and plasma from Malaysia with exposure assessment from consumption of drinking water
    Santhi VA, Sakai N, Ahmad ED, Mustafa AM
    Sci Total Environ, 2012 Jun 15;427-428:332-8.
    PMID: 22578698 DOI: 10.1016/j.scitotenv.2012.04.041
    This study investigated the level of bisphenol A (BPA) in surface water used as potable water, drinking water (tap and bottled mineral water) and human plasma in the Langat River basin, Malaysia. BPA was present in 93% of the surface water samples at levels ranging from below limit of quantification (LOQ; 1.3 ng/L) to 215 ng/L while six fold higher levels were detected in samples collected near industrial and municipal sewage treatment plant outlets. Low levels of BPA were detected in most of the drinking water samples. BPA in tap water ranged from 3.5 to 59.8 ng/L with the highest levels detected in samples collected from taps connected to PVC pipes and water filter devices. Bottled mineral water had lower levels of BPA (3.3±2.6 ng/L) although samples stored in poor storage condition had significantly higher levels (11.3±5.3 ng/L). Meanwhile, only 17% of the plasma samples had detectable levels of BPA ranging from 0.81 to 3.65 ng/mL. The study shows that BPA is a ubiquitous contaminant in surface, tap and bottled mineral water. However, exposure to BPA from drinking water is very low and is less than 0.01% of the tolerable daily intake (TDI).
  12. Mycobacterium leprae reactive T cell clones from lepromatous leprosy patients after prolonged dapsone chemotherapy
    Gill HK, Ridley DS, Ganesan J, Mustafa AS, Rees RJ, Godal T
    Lepr Rev, 1990 Mar;61(1):25-31.
    PMID: 2181222
    The proliferative responses of peripheral blood mononuclear cells (PBMC) to Mycobacterium leprae and BCG were studied in two groups of leprosy patients: a group of 8 lepromatous patients who had been on treatment for more than 20 years (TLL) and a group of 8 untreated lepromatous leprosy patients (ULL). The mean response to M. leprae of the TLL group was 6195 cpm with 5 of the 8 patients responding positively. The mean response to M. leprae of the ULL group was 617 cpm, with only 1 patient showing a positive response. The corresponding proliferative responses to BCG were 19,908 cpm in the TLL group and 7908 in the ULL group. Thirteen M. leprae reactive clones were established from 2 TLL patients and 5 M. leprae reactive clones were established from 2 tuberculoid leprosy patients. Seven of these clones, 4 from the TLL patients and 3 from the tuberculoid (TT) patients could be studied further. Three of the TLL clones responded specifically to M. leprae, while one of the clones exhibited a broad cross-reactivity to other mycobacteria. All of these clones were of the CD4+CD8- phenotype. Our findings suggest that responsiveness to M. leprae can be detected in vitro in a proportion of LL patients who have undergone prolonged chemotherapy, and that this response involves M. leprae reactive CD8+CD8- T cells, of which some appear to be specific to M. leprae.
  13. Fulltext Modelling pedestrian travel time and the design of facilities: a queuing approach
    Rahman K, Ghani NA, Kamil AA, Mustafa A, Kabir Chowdhury MA
    PLoS One, 2013;8(5):e63503.
    PMID: 23691055 DOI: 10.1371/journal.pone.0063503
    Pedestrian movements are the consequence of several complex and stochastic facts. The modelling of pedestrian movements and the ability to predict the travel time are useful for evaluating the performance of a pedestrian facility. However, only a few studies can be found that incorporate the design of the facility, local pedestrian body dimensions, the delay experienced by the pedestrians, and level of service to the pedestrian movements. In this paper, a queuing based analytical model is developed as a function of relevant determinants and functional factors to predict the travel time on pedestrian facilities. The model can be used to assess the overall serving rate or performance of a facility layout and correlate it to the level of service that is possible to provide the pedestrians. It has also the ability to provide a clear suggestion on the designing and sizing of pedestrian facilities. The model is empirically validated and is found to be a robust tool to understand how well a particular walking facility makes possible comfort and convenient pedestrian movements. The sensitivity analysis is also performed to see the impact of some crucial parameters of the developed model on the performance of pedestrian facilities.
  14. Mechanisms of the anti-hypertensive effect of Hibiscus sabdariffa L. calyces
    Ajay M, Chai HJ, Mustafa AM, Gilani AH, Mustafa MR
    J Ethnopharmacol, 2007 Feb 12;109(3):388-93.
    PMID: 16973321
    Previous studies have demonstrated the anti-hypertensive effects of Hibiscus sabdariffa L. (HS) in both humans and experimental animals. To explore the mechanisms of the anti-hypertensive effect of the HS, we examined the effects of a crude methanolic extract of the calyces of HS (HSE) on vascular reactivity in isolated aortas from spontaneously hypertensive rats. HSE relaxed, concentration-dependently, KCl (high K(+), 80 mM)- and phenylephrine (PE, 1 microM)-pre-contracted aortic rings, with a greater potency against the alpha(1)-adrenergic receptor agonist. The relaxant effect of HSE was partly dependent on the presence of a functional endothelium as the action was significantly reduced in endothelium-denuded aortic rings. Pretreatment with atropine (1 microM), L-NAME (10 microM) or methylene blue (10 microM), but not indomethacin (10 microM), significantly blocked the relaxant effects of HSE. Endothelium-dependent and -independent relaxations induced by acetylcholine and sodium nitroprusside, respectively, were significantly enhanced in aortic rings pretreated with HSE when compared to those observed in control aortic rings. The present results demonstrated that HSE has a vasodilator effect in the isolated aortic rings of hypertensive rats. These effects are probably mediated through the endothelium-derived nitric oxide-cGMP-relaxant pathway and inhibition of calcium (Ca(2+))-influx into vascular smooth muscle cells. The present data further supports previous in vivo findings and the traditional use of HS as an anti-hypertensive agent.
  15. Mating calls description of five species of frogs from the genus Hylarana tschudi 1838 (amphibia, anura, ranidae) from Sarawak, Malaysia
    Ramlah Zainudin, Mustafa A. Rahman, Badrul Munir M. Zain, Shukor MN, Norhayati A, Inger RF
    Sains Malaysiana, 2010;39.
    Recordings of frog calls from the genus Hylarana were conducted at seven study sites in Sarawak, Malaysia. The results showed that each species differs in terms of call characteristics, in which a high number of pulsed note belongs to H. baramica, while high repetition note belongs to the sibling species, H. glandulosa. Higher pitched and number of amplitude spectrum, however, belong to H. signata. Pulsed note and note repetition differed significantly among species, except for spectrum amplitude. Advertisement calls for each species were described in detail. This study provide a baseline data on advertisement call characteristics of frogs from the genus Hylarana for future studies of these frogs particularly and the Oriental frogs generally.
  16. Fulltext Low complexity smart grid security protocol based on elliptic curve cryptography, biometrics and hamming distance
    Mutlaq KA, Nyangaresi VO, Omar MA, Abduljabbar ZA, Abduljaleel IQ, Ma J, et al.
    PLoS One, 2024;19(1):e0296781.
    PMID: 38261555 DOI: 10.1371/journal.pone.0296781
    The incorporation of information and communication technologies in the power grids has greatly enhanced efficiency in the management of demand-responses. In addition, smart grids have seen considerable minimization in energy consumption and enhancement in power supply quality. However, the transmission of control and consumption information over open public communication channels renders the transmitted messages vulnerable to numerous security and privacy violations. Although many authentication and key agreement protocols have been developed to counter these issues, the achievement of ideal security and privacy levels at optimal performance still remains an uphill task. In this paper, we leverage on Hamming distance, elliptic curve cryptography, smart cards and biometrics to develop an authentication protocol. It is formally analyzed using the Burrows-Abadi-Needham (BAN) logic, which shows strong mutual authentication and session key negotiation. Its semantic security analysis demonstrates its robustness under all the assumptions of the Dolev-Yao (DY) and Canetti- Krawczyk (CK) threat models. From the performance perspective, it is shown to incur communication, storage and computation complexities compared with other related state of the art protocols.
  17. Leaching of bisphenol A from new and old babies' bottles, and new babies' feeding teats
    Tan BL, Mustafa AM
    Asia Pac J Public Health, 2003;15(2):118-23.
    PMID: 15038686
    Bisphenol A is the monomer used in the manufacture of polycarbonate. Bisphenol A is also known to mimic the female hormone estrogen. In this study, the possibility of the leaching of bisphenol A from polycarbonate babies' bottles and feeding teats was investigated. Bisphenol A was extracted from water samples exposed to the bottles and teats using liquid-liquid extraction. Bisphenol A was analysed by gas chromatograph-mass spectrometer with quadrapole detector in selected ion monitoring mode. Mean leaching of bisphenol A from 100 used babies' bottles when filled with water at 25 degrees C and 80 degrees C were 0.71 +/- 1.65 ng/cm2 (mean +/- standard deviation) and 3.37 +/- 5.68 ng/cm2 respectively. Mean leaching of bisphenol A from 30 new babies' bottles when filled with water at 25 degrees C and 80 degrees C were 0.03 +/- 0.02 ng/cm2 and 0.18 degrees 0.30 ng/cm2 respectively. Bisphenol A was observed to have leached from babies' feeding teats into 37 degrees C water ranged from non-detectable to 22.86 ng/g. The technique employed in this study is fast, reliable and economical.
  18. Fulltext Knowledge and practice of breast self-examination among students in a private higher learning institution in Malaysia
    Nimir, Amal R., Al-Dubai, Sami A. R., Alshagga, Mustafa A., Saliem, Ahmed M.
    Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
    MyJurnal
    Breast cancer is one of the most frequently encountered malignancies among young females in Malaysia, which accounts for 30.4% of newly diagnosed cancers. All women at or above the age of 20 are considered at risk of developing breast cancer. This is a cross-sectional study. The study was conducted in a private medical university in Malaysia during year 2012. Two hundred students were recruited in this study using universal sampling. Data collection was done using a selfadministration questionnaire. Chi-square test was used to assess the association between the practice of breast selfexamination and socio-demographic variables. Only 19.5% of the study sample has sufficient knowledge about BSE which is acquired mostly from local media. Having a family history of malignancy other than breast cancer seems to be the only significant variable associated with knowledge about BSE (P=0.002). Other variables such as demographic data, menstrual history and social history were also tested, but found to be not significant. Frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to alert the women to any abnormal changes in the breasts so that they will be able to seek medical advice immediately.
  19. Fulltext Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations
    Shah R, Rambhatla A, Atmoko W, Martinez M, Ziouziou I, Kothari P, et al.
    World J Mens Health, 2024 Apr 03.
    PMID: 38606865 DOI: 10.5534/wjmh.230333
    PURPOSE: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations.

    MATERIALS AND METHODS: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations.

    RESULTS: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate.

    CONCLUSIONS: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

  20. Fulltext Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations
    Rambhatla A, Shah R, Ziouziou I, Kothari P, Salvio G, Gul M, et al.
    World J Mens Health, 2024 Apr 04.
    PMID: 38606867 DOI: 10.5534/wjmh.230339
    PURPOSE: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA.

    MATERIALS AND METHODS: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process.

    RESULTS: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit.

    CONCLUSIONS: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines.

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