ROLE OF GINKGO BILOBA IN TINNITUS
BASED ON TINNITUS HANDICAP INVENTORY

ABSTRACT AIMS AND OBJECTIVES To evaluate whether there is role of Ginkgo biloba in treatment of tinnitus or not, using Tinnitus Handicap Inventory MATERIAL METHODS: The present prospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu from January 2019 to January 2020 on 90 patients with primary complaint of tinnitus. Inclusion criteria- Age: 20 years or above, Duration of tinnitus > 3 months. Informed consent was taken and all patients were asked to complete the THI-Tinnitus Handicap Inventory. All patients were given 50mg of Ginkgo biloba standardized extract LI 1370 (containing 25% flavonoids, 3% ginkgolides and 5% bilobalides). Patients were advised to take three tablets daily for 12 weeks. RESULTS The mean pre-treatment THI score was 43.6 and mean post-treatment THI score (at 12 weeks) was 39.4; the mean change in THI score was 4.2, the result being statistically insignificant (p-value= 0.43). Out of 90 patients, 51 reported unchanged severity of tinnitus, 27 patients reported improvement in severity of tinnitus and 12 patients reported worsening of condition. CONCLUSION According to our study, Ginkgo biloba has no significant therapeutic role in tinnitus. However, the aetiology of tinnitus is multifactorial and Ginkgo biloba could benefit patients with ischemic aetiology. KEYWORDS Ginkgo, biloba, handicap, inventory, tinnitus

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Evaluation of Transient Elastography in Prediction Of De novo Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

QJM ◽

10.1093/qjmed/hcab107.013 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Nadia abdelaty Abdelkader ◽

Moustafa Hamed Abdelaleem ◽

Mohammed El-Gharib Abo El- maaty ◽

Heba Ismail Aly ◽

Sayed Ahmed Sayed

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transient Elastography ◽

P Value ◽

Hepatic Decompensation ◽

Non Invasive ◽

Prediction Of Mortality ◽

The Mean ◽

One Year

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value < 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value <0.001) .Regarding prediction of mortality, LS at cut off value > 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA

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Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.03.02.08 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

Interleukin 6 ◽

Mean Value ◽

Maternal Serum ◽

P Value ◽

Subclinical Infection ◽

Premature Rupture ◽

Cutoff Value ◽

The Mean ◽

Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

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Considering the hypothesis of the pathophysiology of cellulite in its treatment

Dermatology Reports ◽

10.4081/dr.2017.7352 ◽

2017 ◽

Vol 9 (2) ◽

Author(s):

José Maria Pereira de Godoy ◽

Ana Carolina Pereira de Godoy ◽

Maria de Fatima Guerreiro Godoy

Keyword(s):

Clinical Trial ◽

Medical Records ◽

Ethics Committee ◽

Clinical Treatment ◽

P Value ◽

Lymph Drainage ◽

The Mean ◽

Cervical Stimulation ◽

Alpha Error ◽

Paired T Test

The aim of this study was to evaluate perimetric reductions in the clinical treatment of cellulite (aesthetics) using the Godoy method in a randomized retrospective clinical trial. The medical records of 150 patients treated for cellulite in the period from 2006 to 2011 in the Clinica Godoy were revisited. Treatment comprised manual and mechanical lymph drainage and cervical stimulation for one hour per day over 10 days. The paired t-test was used for statistical analysis, with an alpha error of 5% (P-value <0.05) being considered acceptable. This study was started after being approved by the Research Ethics Committee of the Medicine School in São José do Rio Preto (FAMERP - no. 395- 2010), Brazil and after being registered as a clinical trial. The mean reduction of the 150 patients was 3.81±2.76 g (P-value <0.0001; 95% confidence interval: 3.408-4.223). A significant reduction in size was seen with the clinical treatment of cellulite giving an improvement in the physical appearance. Pathophysiological mechanisms such as regional skin lymphostasis seem to be involved in the formation of cellulite.

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Association of high BNP level with heart failure in patients presenting with STEMI.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.04.6030 ◽

2021 ◽

Vol 28 (04) ◽

pp. 491-496

Author(s):

Muhammad Waqas ◽

Hafiz Muhammad Faiq Ilyas ◽

Irfan Majeed ◽

Muhammad Nouman Ahmad ◽

Muhammad Nazim ◽

...

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Informed Consent ◽

Study Design ◽

Inclusion Criteria ◽

Demographic Information ◽

Female Ratio ◽

The Mean ◽

Male To Female ◽

Study Setting

Objective: The objective of this study is to to determine the association of high BNP level with heart failure in patients presenting with STEMI. Study Design: Cohort Study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 01 January 2017 to 30 June 2017. Material & Methods: After meeting the inclusion criteria 150 patients were enrolled. Informed consent and demographic information was taken. Then patients divided in two groups, high and normal BNP groups. Then patients were admitted in cardiology wards and were followed-up there for 5 days. Patients evaluated for symptoms of heart failure and underwent echocardiography for confirmation of presence or absence of heart failure. All the collected data was entered and analyzed on SPSS version 21. Results: In this study the mean age high BNP group was 48.87± 10.18 years while the mean age in normal BNP group was 48.99±12.15 years. Male to female ratio of the patients was 2:1. The heart failure occurred in 19(12.67%) patients. There is 1.58 times higher risk of heart failure in high BNP than normal BNP i.e. RR=1.58[1.14-2.19]. Conclusion: This present study concluded that high BNP level is strongly associated with heart failure in patients presenting with STEMI.

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Rendahnya Praktik Menyusui pada Ibu Post Sectio Caesarea dan Dukungan Tenaga Kesehatan di Rumah Sakit

Kesmas National Public Health Journal ◽

10.21109/kesmas.v8i8.410 ◽

2014 ◽

Vol 8 (8) ◽

pp. 393

Author(s):

Dwi Retno Wulandari ◽

Linda Dewanti

Keyword(s):

Informed Consent ◽

Health Professional ◽

Health Workers ◽

Sectio Caesarea ◽

P Value ◽

Feeding Practice ◽

Breastfeeding Initiation ◽

Breastfeeding Practices ◽

Breastfeeding Practice

Penelitian terdahulu menyebutkan bahwa ibu melahirkan secara sectio caesarea cenderung lebih lambat melakukan inisiasi menyusu dini dan mempunyai prevalensi lebih rendah dalam praktik ASI ekslusif dibanding Ibu melahirkan pervaginam. Ibu post sectio caesarea juga tidak memulai menyusui bayinya pada hari pertama melahirkan. Tujuan penelitian ini adalah mengetahui faktor yang menyebabkan rendahnya praktik inisiasi ASI pada Ibu post sectio caesarea termasuk peran tenaga kesehatan di sebuah rumah sakit di Surabaya. Sebanyak 72 ibu yang melahirkan secara sectio caesarea selama bulan Juni 2012 telah menandatangani informed consent, diobservasi sejak masuk rumah sakit sampai akhir hari ke-2 post sectio caesarea, dan diwawancara dengan menggunakan kuesioner. Hasil penelitian menunjukkan semua ibu sudah mempunyai pengetahuan yang baik tentang ASI, 26,4% di antaranya sudah mempunyai pengalaman sebelumnya dalam memberikan ASI, tetapi hanya 6,9% dan total 29,2% yang mulai memberikan ASI pada hari pertama dan kedua pasca sectio caesarea. Dukungan tenaga kesehatan dalam hal membantu proses pemberian ASI dilaporkan masih rendah. Uji korelasi mendapatkan bahwa dukungan tenaga kesehatan dan kondisi rawat gabung adalah faktor yang berhubungan dengan praktik pemberian ASI (p value 0,39; p = 0,001; phi value = 0,47; p = 0,001). Rendahnya pemberian ASI ibu pasca sectio caesarea berkorelasi dengan rendahnya dukungan tenaga kesehatan dan penundaan rawat gabung.Previous studies showed that breastfeeding initiation was late in babies born with sectio caesarea compared to those with vaginal delivery and prevalence of exclusive breastfeeding practice was low in the former group. There was no breastfeeding initiation in the first day of post sectio caesarea. The objective of this study was to define factors correlated to low breast feeding practice initiation on post sectio caesarea mother, including the role of health workers in a hospital in Surabaya. 72 post sectio caesarea mothers were observed and interviewed on 1-30 June 2012 to find the factors correlated with breastfeeding practice. The results showed that although all the mothers already had a good knowledge about breastfeeding, and 26.4% of them had previous experience in breastfeeding, only 6.9% and 29.2% of total breastfeeding is started on the first and second post sectio caesarea respectively. Support for breastfeeding practice from health workers was low, and there were significant correlation between the support and rooming conditions with breastfeeding practices (p = 0.001). We concluded that low level of breastfeeding practice on mother with sectio caesarea correlated with low support of health professional and with the delay of room-in practice.

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EFFICACY OF CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN AND ULTRAVIOLET-A IN PROGRESSIVE KERATOCONUS.

10.36106/ijsr/3021115 ◽

2020 ◽

pp. 1-3

Author(s):

Priyanka Raut ◽

Nikhilesh * Wairagade ◽

Praneeta Sakarkar

Keyword(s):

P Value ◽

Spherical Equivalent ◽

Ultraviolet A ◽

Collagen Crosslinking ◽

Institutional Ethics ◽

Uncorrected Visual Acuity ◽

Corneal Collagen Crosslinking ◽

The Mean ◽

A Prospective Study ◽

Corneal Collagen

PURPOSE-To evaluate outcomes of collagen crosslinking in patients having progressive keratoconus. METHODS- A prospective study was done in eyes that underwent corneal collagen crosslinking for treatment of progressive keratoconus. This study was performed after approval from Institutional Ethics Committee and informed consent was obtained from all the patients. Data was analysed with the help of JASP0.8.3.1 and MS-Excel 2013. RESULT-The mean age was 20.94 ± 2.04 years. 21 (63.63%) were males, 12 (36.36 %) were females. The mean uncorrected visual acuity (UCVA) pre-operative and post-operative at 6 months were 0.64 ± 0.37 and 0.53 ± 0.31 (logMAR) respectively (p value 0.03). Mean spherical equivalent pre-operatively and post-operatively at 6 months were -2.85 ± 2.14 and -2.38 ± 1.70 respectively (p < 0.001). Mean keratometry (Mean K) preoperative and post-operative were 49.85 ± 4.10 Dioptres (D) and 49.22 ± 4.09 D respectively (p = 0.0007). CONCLUSION- Corneal collagen crosslinking with UV-A and riboavin is a safe and effective method for halting the deterioration of progressive keratoconus.

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Serum Neutrophil Gelatinase-Associated Lipocalin Levels In Early Detection Of Contrast-Induced Nephropathy

Clinical & Investigative Medicine ◽

10.25011/cim.v39i3.26797 ◽

2016 ◽

Vol 39 (3) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

Murat Muratoglu ◽

Cemil Kavalci ◽

Elif Kilicli ◽

Meliha Findik ◽

Afşin Emre Kayipmaz ◽

...

Keyword(s):

Early Detection ◽

P Value ◽

Ngal Level ◽

Contrast Induced Nephropathy ◽

Sodium Potassium ◽

Neutrophil Gelatinase Associated Lipocalin ◽

The Mean ◽

Neutrophil Gelatinase ◽

Over Time

Purpose: The purpose of this study was to investigate the role of serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early detection of contrast-induced nephropathy (CIN). Methods: This prospective study enrolled 74 patients undergoing abdominal tomography with contrast (1 November 2014 - 28 February 2015). Demographic properties (age and sex), symptoms and CT examination results were analysed. Sodium, potassium, urea, creatinine and NGAL levels were measured at 0th, 6th, and 72nd hours. P value < 0.05 was considered statistically significant. Results: CIN developed in 16.2% of the study patients. The mean age was significantly higher in the patients who developed CIN (p0.05). Urea levels did not differ significantly between the groups at 0th and 6th hours (p>0.05) but was significantly higher in the patients with CIN at 72nd hour (p0.05). Creatinine level was not significantly different between the groups (p>0.05) but increased significantly over time (p>0.05). There were no significant differences between the groups with respect to NGAL levels at 0th and 72nd hours (p>0.05) whereas the group with CIN had a significantly higher NGAL level at 6th hour (p

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Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191098 ◽

2019 ◽

Vol 8 (4) ◽

pp. 674

Author(s):

Shreshth Khanna ◽

Suman Bala ◽

Yashpal Singh ◽

Taruna Sharma ◽

Juhi Kalra ◽

...

Keyword(s):

Valproic Acid ◽

Cognitive Impairment ◽

Cognitive Decline ◽

P Value ◽

Cognitive Improvement ◽

Institutional Ethics ◽

Group A ◽

The Mean ◽

Group B ◽

The Impact

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.

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Pharmacometabolomics of Bronchodilator Response in Asthma and the Role of Age-Metabolite Interactions

Metabolites ◽

10.3390/metabo9090179 ◽

2019 ◽

Vol 9 (9) ◽

pp. 179 ◽

Cited By ~ 1

Author(s):

Rachel S. Kelly ◽

Joanne E. Sordillo ◽

Sharon M. Lutz ◽

Lydiana Avila ◽

Manuel Soto-Quiros ◽

...

Keyword(s):

Asthma Management ◽

Management Program ◽

P Value ◽

Bronchodilator Response ◽

Age Related ◽

Children With Asthma ◽

The Mean ◽

Interaction With Age ◽

Effect Of Age

The role of metabolism in modifying age-related differential responses to asthma medications is insufficiently understood. The objective of this study was to determine the role of the metabolome in modifying the effect of age on bronchodilator response (BDR) in individuals with asthma. We used longitudinal measures of BDR and plasma metabolomic profiling in 565 children with asthma from the Childhood Asthma Management Program (CAMP) to identify age by metabolite interactions on BDR. The mean ages at the three studied time-points across 16 years of follow-up in CAMP were 8.8, 12.8, and 16.8 years; the mean BDRs were 11%, 9% and 8%, respectively. Of 501 identified metabolites, 39 (7.8%) demonstrated a significant interaction with age on BDR (p-value < 0.05). We were able to validate two significant interactions in 320 children with asthma from the Genetics of Asthma in Costa Rica Study; 2-hydroxyglutarate, a compound involved in butanoate metabolism (interaction; CAMP: β = −0.004, p = 1.8 × 10−4; GACRS: β = −0.015, p = 0.018), and a cholesterol ester; CE C18:1 (CAMP: β = 0.005, p = 0.006; GACRS: β = 0.023, p = 0.041) Five additional metabolites had a p-value < 0.1 in GACRS, including Gammaminobutyric acid (GABA), C16:0 CE, C20:4 CE, C18.0 CE and ribothymidine. These findings suggest Cholesterol esters and GABA may modify the estimated effect of age on bronchodilator response.

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227 CALRETICULIN, A 60-kDa PROTEIN, PREVENTS POLYSPERMY IN ZONA PELLUCIDA-FREE PIG OCYTES

Reproduction Fertility and Development ◽

10.1071/rdv25n1ab227 ◽

2013 ◽

Vol 25 (1) ◽

pp. 261

Author(s):

R. Romar ◽

C. Soriano-Úbeda ◽

M. D. Saavedra ◽

J. Gadea ◽

M. Avilés ◽

...

Keyword(s):

Zona Pellucida ◽

Calcium Binding ◽

Statistical Significance ◽

P Value ◽

Oocyte Activation ◽

Cortical Granules ◽

Chaperone Protein ◽

The Mean

After gamete membrane fusion or artificial oocyte activation, cortical granules undergo exocytosis and the released content modifies the zona pellucida (ZP), preventing polyspermy. Calreticulin (CRT), a calcium-binding highly conserved protein of 60 kDa, is contained in cortical granules from hamster eggs (Muñoz-Gotera et al. 2001 Mol. Reprod. Dev. 60), and we recently showed it is exocytosed from chemically activated ZP-free pig oocytes (Romar et al. 2012 Reprod. Fertil. Dev. 24). When pig ZP-enclosed oocytes were incubated with CRT, monospermy was not improved (Romar et al. 2011, Maternal communication with gametes and embryo, p. 72), suggesting that the likely role of CRT in preventing polyspermy might be carried out at the oolemma level. Our objective was to evaluate whether CRT prevents polyspermy in pig ZP-free oocytes by treating the cells with this protein before being inseminated. In vitro-matured cumulus–oocyte complexes (44 h, NCSU-37 medium) were decumulated and ZP was digested with Tyrode’s acid. The ZP-free oocytes were incubated for 30 min in TALP medium supplemented with 0, 100, 1000, and 5000 pg of CRT (ab91577, Abcam, Cambridge, MA, USA) per oocyte. After washing, ZP-free oocytes were inseminated (25 000 sperm mL–1) and gametes were co-cultured for 18 h. Putative zygotes were fixed and stained with Hoechst 33342 to analyse the fertilization results. Four replicates with 30 to 35 oocytes per group were done, and results were analysed by one-way ANOVA. A P-value ≤0.05 was taken to denote statistical significance. Incubation with CRT did not affect penetration rates that were similar among groups (77.12 ± 3.88 and 72.73 ± 4.07, respectively, for the 0- and 5000-pg CRT groups). However, the mean number of sperm per penetrated oocyte decreased from 3.01 ± 0.28 (0-pg group) to 2.07 ± 0.16 (5000-pg group), and monospermy rate increased from 30.77 ± 4.87 (0-pg group) to 52.27 ± 5.36 (5000-pg group; P ≤ 0.05). Incubation with CRT did not affect the number of sperm attached to oolemma, which was similar among all groups (11.45 ± 1.16 v. 10.75 ± 1.17, respectively, for 0 and 5000 pg of CRT). These preliminary data suggest that CRT, a protein exocytosed after oocyte activation, participates in the membrane block to polyspermy in pigs. Future studies to describe the exact mechanism of action of this chaperone protein are necessary. Supported by MEC and FEDER (AGL2009-12512-C02-01).

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