BackgroundImplantation defect is one of these contributing factors for unexplained infertility. In the mid-luteal phase, when implantation is expected to happen, Integrins expression is remarkably increased. So, Integrins could potentially serve as markers for the frame of the window of implantation. αVβ3 integrin could have a role as a potential receptor for embryonic attachment. The aim of the current study is to investigate whether the women with unexplained infertility have a pattern of expression of endometrial αvβ3 integrin that could differ from those who have normal fertility or not.MethodTwo groups of women have been included in this study. The first group was the Unexplained Infertility Group. This group included women diagnosed with unexplained primary infertility. The second group was the fertile Group, which included fertile parous women presented to the family planning clinic seeking contraception. 2D transvaginal ultrasound scan (TVS) was performed six days after detecting urinary LH surge. (TVS) was used to measure endometrial thickness, and subendometrial blood flow color Doppler Resistance Index (RI). On the same day of transvaginal ultrasound, endometrial samples were taken using the Endocell® office suction sampler for Immunohistochemistry (IHC) study using monoclonal mouse IgG antibodies to detect endometrial αvβ3 integrin.ResultsThirty-five fertile women with a diagnosis of unexplained infertility were included as a group I [Unexplained infertility Group] along with an equal number of fertile women as group II [Fertile Group]. The group of women with a diagnosis of unexplained infertility had a significantly lower αvβ3 integrin score when compared to the fertile group (median score 0, range:0–2 and median score 1, range: 1–3 and for infertile and fertile groups respectively, P < 0.0001). In addition, the unexplained infertility group had significantly higher subendometrial flow RI and Significantly thinner endometrial thickness.ConclusionThis study showed that Alpha v Beta 3 integrin is a significantly lower in endometrium in cases of unexplained infertility, which may suggest that underexpression of Alpha v Beta 3 integrin in human endometrium could be linked to defective uterine receptivity, and play a role as an unrecognized cause of infertility in this population of women. We need larger studies of adequate statistical power, ideally investigating more than one menstrual cycle in the same woman, to investigate the usefulness of using these molecular molecules in clinical practice.

Visceral leishmaniasis (VL) is one of the neglected tropical diseases that require a global policy for integrated control programs. The disease is fatal if untreated, affects ∼500,000 persons/year, and is most prevalent in poor countries. Treatment is expensive and carries a risk of toxicity. Therefore, sensitive and specific diagnosis of VL is crucial to avoid under- or overdiagnosis. Selecting an appropriate serological diagnostic test is an issue of controversy and depends on geographic location. The study aimed to evaluate the performance of two serological techniques: recombinant antigen K39 (rK39)-immunochromatographic (IC) lateral flow assay (InBios, USA) that uses a recombinant Leishmania antigen K39 and the specific IgG detection by direct agglutination test (DAT, for the diagnosis of imported VL in non-endemic region (Saudi Arabia). The diagnostic accuracy of the two assays was assessed using bone marrow aspiration, direct microscopic examination, and culture on NNN agar as the "gold standard". The bone marrow specimens from Indian, Sudanese, and Bengali patients (n = 98) with suspected VL features were cultured. Thirty-five specimens were positive (36%). The sensitivity and specificity of rK39-IC test were 89% (95% CI 78-99) and 92% (95% CI 85-99), respectively. DAT (with cutoff ≥1:1,600) showed comparable results (sensitivity 94%; 95% CI 87-101 and specificity 95%; 95% CI 90-100). To conclude, the performance of rK39-IC test and DAT is comparable. Both tests are moderately sensitive and specific and could be used to facilitate the global drive to eliminate this disease. The rK39-IC test is a rapid, easy-to-perform test and can be used as a point-of-care diagnostic method.

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The study describes the pattern of childhood neuromuscular disorders seen in a decade (1982-1992) at King Khalid University Hospital, Riyadh, Saudi Arabia. Similar data are scanty outside Europe and North America, and lacking in Saudi Arabia. Eighty-four children (< or = 16 years) were assigned to an entity of neuromuscular disease following review of the clinical, biochemical and neurophysiological data, and after re-examination of the histological and histochemical features of the muscle biopsies. Of the 84 ascertained cases, 40 (48%) had different forms of muscular dystrophy (MD), 26 (31%) had one of the various types of spinal muscular atrophy (SMA) and two (2.4%) hereditary motor and sensory neuropathy type I. The rest were miscellaneous cases including one (1.2%) with dermatomyositis. Of the dystrophies, severe childhood autosomal recessive muscular dystrophy (SCARMD) was more prevalent (30%) than Duchenne type (25%), conforming with observations from North African countries known to have a high incidence of consanguineous marriages. Family history of other cases of SCARMD included three males and three females, one of whom died at 15 years, and consanguinity was evident in 63%. Congenital MD, inherited in an autosomal recessive pattern, was also common (30%). A history of consanguinity was present in 55%. Of the 26 cases of SMA, type I (Werdnig-Hoffman disease) was the most prevalent (69%). Consanguinity was ascertained in 65% of SMA families and histories revealed another 14 affected siblings. Autosomal recessive forms seem to constitute the bulk of neuromuscular disorders in Saudi Arabia.

A 36-year-old laborer presented with bilocular swelling, bulging above and below the flexor retinaculum of the right hand with transmitted fluid impulse. A clinical diagnosis of compound palmar ganglion of tuberculous nature was made at the time of surgery, and confirmed later by pathological examination. Complete excision of the ganglion was performed, followed by oral anti-tuberculous drugs for 9 months. The patient was cured. This is a rare condition and the current knowledge about its pathology and management is reviewed.H Wali, S Al-Khuwaitir, MA Hafeez, Compound Palmar Ganglion: A Case Report and Literature Review. 1986; 6(1): 55-58