Background: Informed consent (IC) is a healthcare standard emphasizing the meaning of human dignity as clarified in The Universal Declaration of Human Rights. Data about IC practices in Egypt is insufficient. This study aimed to describe the Egyptian patients ‘or guardians ‘experience about IC and their expectations about its meaning in general and according to type of healthcare facility. Methods: Self-administered questionnaire to 1092 participants who had undergone or were scheduled to a procedure requiring an IC at three types of Egyptian health care facilities. Ten statements were ranked twice by the participants to reflect their perception of IC purpose as per what is currently practiced then as per what they believe should be practiced. Results: Informed consent implementation varies across the different levels of health care facilities in Egypt; being implemented the most at the non-governmental health facilities (in 85.9 % of procedures) followed by the governmental health care facilities (77.8 %) and the least at the university hospitals (63.8 %). Current practice was perceived to: “Help patient/guardian decide”, “Document patient’s/guardian’s decision”, and “Have shared decision” (ranked 1–5 by 64.9%, 59.3 %, and 57.3% of respondents, respectively). The perceived purpose of IC was to: “Inform the patient/guardian”, “Make sure patient/guardian understand” and “Document patient’s/guardian’s decision” (ranked 1–5 by 68.4%, 65.3 %, and 65.1% of respondents, respectively). Conclusion: The use of IC is common in Egyptian medical practice but varies across healthcare facilities. Participants believe that the current purpose of IC is to help in decision making, and its main purpose should be information disclosure. There is consensus agreement that both documenting the patient’s/guardian’s decision and informing the patient /guardian is considered as important current as well as preferred practices. IC should be an integral part of any procedure with more emphasis on seeking assent children whenever appropriate. Keywords: Informed consent, Arab Culture, Norm perception, Current practice.

This experiment was conducted to evaluate the impact of dietary L-arginine supplementation on some epididymal spermatozoa characteristics, differential White blood cells count, some reproductive organs'metrics. Fifteen adult Ossimi rams averaging 44.9± 0.57 kg were utilized, divided into three comparable groups (5 rams each) , were fed a basal ration supplemented with L-arginine at concentration of 0.0 (G1) or 0.5(G2) or 1.0%(G3) of body weight/day for two months. At the end of the study rams were slaughtered for conducting biometric studies on tests and epididymis and testicular Immunohistochemical NOS analysis. Epididymis Semen was collected and evaluated for motility, viability, abnormality and acrosome integrity.L-arginine Supplementation at 0.5(G2) or 1.0%(G3) significantly (P<0.05) improved epididymal spermatozoa characteristics, as % of motility, livability, acrosome integrity while, % of dead and abnormal spermatozoa decreased in supplemented groups as compared with G1. This improving was greatest in G2 than that happened in G3. Measurements of testes and epididymis increased in G2 and G3 compared with G1 . In addition, there was a significant increase of immunoexpression of testicular Nitric oxide synthase (NOS) in rams received L-arginine at 1% or 0.5% of body weight/day as compared to G1, and this expression was clearly found within the spermatid layer and few sertoli cells in both treated groups, while in G1, it was limited to spermatid layer only. . It could be concluded that dietary L-arginine supplementation to Ossimi ram ration has positive effects on epididymal spermatozoa characteristics, Sexual organs anthropometries and immunohistochemical expression of testicular NOS.

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This study aimed to investigate the effect of MOl or MSC supplementation on some blood constituents, semen characteristics, testis and epididymis measurements in Barki rams. Fifteen Barki rams aged 10-12 months divided into three similar groups (5each). Rams in G1 were fed the basal diet supplemented by MOL (5% of CFM), rams in G2 fed the basal diet supplemented by MSC (10% of CFM) while rams in G3 (control) were fed the basal diet without supplements. Blood samples were collected and erythrocytes, Hb, PLT, PCV, MCV, MCH, MCHC, ALT, AST, glucose, uric acid, creatinine and testosterone were determined. Semen was collected and semen physical characteristics as well as of the epididymis and testes biometric were evaluated. Results indicated that MOL and MSC supplementation to ram rations significantly affected glucose, creatinine, urea, ALT, AST and testosterone levels, and insignificantly on erythrocyte, Hb, PLT, PCV, MCV, MCH, and MCHC. In this regard, MOL supplementation to ram rations increased MCV, PLT and decreased RBCs, Hg, MCH, MCHC, and PCV; while, MSC supplementation increased RBCs, Hg, MCHC, PLT, and urea. The addition of MOL or MSC increased ALT, AST, and creatinine, and decreased testosterone and glucose levels. Both supplementation (MOL or MSC) in Barki rams' feed improved most characteristics of semen such as volume, motility, vitality and normality, and reduced mortality and abnormalities and there is no significant effect on testes measurements. The highest testicular weight and width were observed in the MOL group. The testicular size was relatively higher for rams fed a moringa-free diet compared to those supplemented with MOL or MSC. It could be concluded that supplementation of MOL and MSC rations into Barki rams' rations improved most of the semen characteristics (volume, motility, vitality and normality) and reduced mortality and malformations. However, it negatively affects kidney function (increased urea and creatinine) and liver enzyme activities (ALT & AST).

The aim of this study is to determine the effect of the melatonin addition to the maturation medium (MM) on in vitro maturation of buffalo oocytes (IVM). Maturation is evaluated by the cumulus cells expansion and nuclear maturation. The cumulus oocyte complexs (COCs) were harvested by aspiration of antral follicles (2-8 mm diameter) of slaughter buffalo ovaries, COCs with homogeneous cytoplasm and at least three layers of cumulus cells were selected. The COCs were incubated for 24h in TCM-199 medium with melatonin (10, 30 or 50ng/ml) or without addition (control). After 24 h in culture media, the maturation rate of oocytes was determined by evaluating the expansion degree of the cumulus-oocyte complex (COCs) in each treatment, then classified into: fully expanded, partially expanded or not expanded, and by evaluation stages of oocyte nuclear maturation (GV, GVBD, MI, MII or degenerated). Results illustrate that supplementation maturation media with 10 and 30, 50 ng/ml melatonin resulted in increasing the cumulus cell expansion of buffaloes oocytes by 86.4, 82.3, 83.2 %, respectively, as compared with oocytes cultured with melatonin-free medium (73.3%), The respective differences were significant. Majority of this improvement in the expansion rates of oocytes was observed in the rate of fully expanded oocytes, On the contrary, the rate of immature (unexpanded) oocytes incubated in melatonin-free medium was significantly (P<0.01) higher (26.7%) than those incubated in maturation media with 10 or 30 or 50 ng/ml melatonin (13.8, 17.7, 16.9 %, respectively). Moreover, results indicated that addition of melatonin to the maturation medium significantly improved the percentage of oocytes of first polar body (matured to MII) as compared with those incubated without melatonin, the highest percentage of those oocytes was obtained with 10 ng/ml melatonin (7.85 %), however, the least percentage was in those oocytes cultured with melatonin-free medium (48.6%) with significant differences (P<0.05). On the other side, the percentage of oocytes of GVBD, MI or degenerated stages did not significantly affected with melatonin addition (10. 30 or 50 ng/ml) to culture media as compared with those cultured without melatonin medium. It could be concluded that addition of melatonin to the MM improved cumulus expansion and nuclear maturation rate of buffalo oocytes.