Background :Neuroaxial anesthesia for patients with cardiac disease is still a matter of debate . BNP has been added as a cardiac biomarker in response to stress. Spinal-epidural anesthesia seems to full fill some criteria of therapeutic intervention in cardiac patients. For this , in a group of patients with impaired left ventricular function , we test whether epidural –spinal anesthesia has an effect on BNP as well as testing the predictability of postoperative BNP for outcome. Methods : the authors conducted this study on 24 lower extremity vascular surgery patients with ischemic dilated cardiomyopathy ( EF 40 % ) under CSE .the primary end point was the cardiac outcome over 6 months postoperatively, the secondary outcome was the effect of CSE on postoperative BNP and its predictability for the outcome . Results : CSE offers perioperative hemodynamic stability ,and complication free early hospital stay period , but mortality and morbidity rates were 8% and 41.6 % respectively over the next 6 months . postoperative BNP ≥67.43pg/ml , provided the optimal BNP cutoff points for predicting major cardiac complications In conclusion, CSE is a feasible technique of anesthesia in such patients with dilated cardiomyopathy undergoing vascular surgery in the lower half of the body . BNP study revealed that postoperative BNP levels are valuable bed side predictors of intermediate term post-operative cardiac death and major adverse cardiac events in

Background :Neuroaxial anesthesia for patients with cardiac disease is still a matter of debate . BNP has been added as a cardiac biomarker in response to stress. Spinal-epidural anesthesia seems to full fill some criteria of therapeutic intervention in cardiac patients. For this , in a group of patients with impaired left ventricular function , we test whether epidural –spinal anesthesia has an effect on BNP as well as testing the predictability of postoperative BNP for outcome. Methods : the authors conducted this study on 24 lower extremity vascular surgery patients with ischemic dilated cardiomyopathy ( EF 40 % ) under CSE .the primary end point was the cardiac outcome over 6 months postoperatively, the secondary outcome was the effect of CSE on postoperative BNP and its predictability for the outcome . Results : CSE offers perioperative hemodynamic stability ,and complication free early hospital stay period , but mortality and morbidity rates were 8% and 41.6 % respectively over the next 6 months . postoperative BNP ≥67.43pg/ml , provided the optimal BNP cutoff points for predicting major cardiac complications In conclusion, CSE is a feasible technique of anesthesia in such patients with dilated cardiomyopathy undergoing vascular surgery in the lower half of the body . BNP study revealed that postoperative BNP levels are valuable bed side predictors of intermediate term post-operative cardiac death and major adverse cardiac events in

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The effect of being overweight on seminal variables was assesed in 165 fertile men. Participants were divided into three groups: fertile men with normal body mass index (BMI) (18.5-24.9 kg/m2), fertile overweight men (BMI 25-29.9 kg/m2) and fertile obese men (BMI >30 kg/m2). Medical history was taken, a clinical examination conducted. Semen analysis was undertaken and BMI measured. Seminal reactive oxygen species (ROS) was estimated by chemiluminescent assay, sperm vitality by the hypo-osmotic swelling test and sperm DNA fragmentation by propidium iodide staining with flowcytometry. Fertile obese men had significantly lower sperm concentration, progressive sperm motility and sperm normal morphology, with significantly higher seminal ROS and sperm DNA fragmentation compared with fertile normal-weight men and overweight men (all P 0.05). BMI was negatively correlated with sperm concentration (r = -0.091; P = 0.014), progressive sperm motility (r = -0.697; P = 0.001), normal sperm morphology (r = -0.510; P = 0.001), sperm vitality (r = -0.586; P = 0.001), but positively correlated with sperm DNA fragmentation percentage (r = 0.799; P = 0.001) and seminal ROS (r = 0.673; P = 0.001). Increased BMI was found to affect semen parameters negatively even in fertile men.

The effect of being overweight on seminal variables was assesed in 165 fertile men. Participants were divided into three groups: fertile men with normal body mass index (BMI) (18.5-24.9 kg/m2), fertile overweight men (BMI 25-29.9 kg/m2) and fertile obese men (BMI >30 kg/m2). Medical history was taken, a clinical examination conducted. Semen analysis was undertaken and BMI measured. Seminal reactive oxygen species (ROS) was estimated by chemiluminescent assay, sperm vitality by the hypo-osmotic swelling test and sperm DNA fragmentation by propidium iodide staining with flowcytometry. Fertile obese men had significantly lower sperm concentration, progressive sperm motility and sperm normal morphology, with significantly higher seminal ROS and sperm DNA fragmentation compared with fertile normal-weight men and overweight men (all P 0.05). BMI was negatively correlated with sperm concentration (r = -0.091; P = 0.014), progressive sperm motility (r = -0.697; P = 0.001), normal sperm morphology (r = -0.510; P = 0.001), sperm vitality (r = -0.586; P = 0.001), but positively correlated with sperm DNA fragmentation percentage (r = 0.799; P = 0.001) and seminal ROS (r = 0.673; P = 0.001). Increased BMI was found to affect semen parameters negatively even in fertile men.

The effect of being overweight on seminal variables was assesed in 165 fertile men. Participants were divided into three groups: fertile men with normal body mass index (BMI) (18.5-24.9 kg/m2), fertile overweight men (BMI 25-29.9 kg/m2) and fertile obese men (BMI >30 kg/m2). Medical history was taken, a clinical examination conducted. Semen analysis was undertaken and BMI measured. Seminal reactive oxygen species (ROS) was estimated by chemiluminescent assay, sperm vitality by the hypo-osmotic swelling test and sperm DNA fragmentation by propidium iodide staining with flowcytometry. Fertile obese men had significantly lower sperm concentration, progressive sperm motility and sperm normal morphology, with significantly higher seminal ROS and sperm DNA fragmentation compared with fertile normal-weight men and overweight men (all P 0.05). BMI was negatively correlated with sperm concentration (r = -0.091; P = 0.014), progressive sperm motility (r = -0.697; P = 0.001), normal sperm morphology (r = -0.510; P = 0.001), sperm vitality (r = -0.586; P = 0.001), but positively correlated with sperm DNA fragmentation percentage (r = 0.799; P = 0.001) and seminal ROS (r = 0.673; P = 0.001). Increased BMI was found to affect semen parameters negatively even in fertile men.

The effect of being overweight on seminal variables was assesed in 165 fertile men. Participants were divided into three groups: fertile men with normal body mass index (BMI) (18.5-24.9 kg/m2), fertile overweight men (BMI 25-29.9 kg/m2) and fertile obese men (BMI >30 kg/m2). Medical history was taken, a clinical examination conducted. Semen analysis was undertaken and BMI measured. Seminal reactive oxygen species (ROS) was estimated by chemiluminescent assay, sperm vitality by the hypo-osmotic swelling test and sperm DNA fragmentation by propidium iodide staining with flowcytometry. Fertile obese men had significantly lower sperm concentration, progressive sperm motility and sperm normal morphology, with significantly higher seminal ROS and sperm DNA fragmentation compared with fertile normal-weight men and overweight men (all P 0.05). BMI was negatively correlated with sperm concentration (r = -0.091; P = 0.014), progressive sperm motility (r = -0.697; P = 0.001), normal sperm morphology (r = -0.510; P = 0.001), sperm vitality (r = -0.586; P = 0.001), but positively correlated with sperm DNA fragmentation percentage (r = 0.799; P = 0.001) and seminal ROS (r = 0.673; P = 0.001). Increased BMI was found to affect semen parameters negatively even in fertile men.

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