Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Fahad M. Alshehri; Mahboob H. Akbar; Adel K. Altwairgi; Omar J. AlThaqufi

doi:10.15537/smj.2015.12.12755

References

↵
1. Unlu M,
2. Orguc S,
3. Serter S,
4. Pekindil G,
5. Pabuscu Y
(2007) Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome. Scand J Urol Nephrol 4:42–46.
OpenUrl
↵
1. Iannicelli E,
2. Sessa B,
3. Sapori A,
4. Cappucci M,
5. Briani C,
6. Federici GF,
7. Di Pietropaolo M,
8. Merola S
(2013) [Scrotal ultrasound: anatomy and pathological findings]. Clin Ter 16:63–75, Italian.
OpenUrl
↵
1. Pajovic B,
2. Dimitrovski A,
3. Radojevic N,
4. Vukovic M
(2015) Comparison of sperm parameters in patients with infertility induced by genital infection versus varicocele. Balkan Med J 32:255–259.
OpenUrl
1. Huk J,
2. Fryczkowski M,
3. Kaletka Z,
4. Szwedkowski M
(2006) Comparison of testicular volume before and after laparoscopic varicocelectomy in children and adolescents. Med Wieku Rozwoj 10:885–891.
OpenUrl PubMed
↵
1. Baazeem A,
2. Belzile E,
3. Ciampi A,
4. Dohle G,
5. Jarvi K,
6. Salonia A,
7. Weidner W,
8. Zini A
(2011) Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol 6:796–808.
OpenUrl
↵
1. Babaei Jandaghi A,
2. Moradi H,
3. Hamidi Madani A,
4. Nasseh H,
5. Keshavarz Zirak A,
6. Pourghorban R
(2014) Real-time scrotal ultrasound of patients with varicoceles: correlation with impaired semen analysis. Eur Radiol 24:2245–2251.
OpenUrl
↵
1. Pilatz A,
2. Altinkilic B,
3. Köhler E,
4. Marconi M,
5. Weidner W
(2011) Color doppler ultrasound imaging in varicoceles: is the venous diameter sufficient for predicting clinical and subclinical varicocele? World J Urol 29:645–650.
OpenUrl CrossRef PubMed
↵
1. Kim YS,
2. Kim SK,
3. Cho IC,
4. Min SK
(2015) Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis. Korean J Urol 56:144–147.
OpenUrl
1. Liguori G,
2. Trombetta C,
3. Garaffa G,
4. Bucci S,
5. Gattuccio I,
6. Salamè L,
7. Belgrano E
(2004) Color Doppler ultrasound investigation of varicocele. World J Urol 22:378–381.
OpenUrl CrossRef PubMed Web of Science
1. Schurich M,
2. Aigner F,
3. Frauscher F,
4. Pallwein L
(2009) The role of ultrasound in assessment of male fertility. Eur J Obstet Gynecol Reprod Biol 144:192–198.
OpenUrl CrossRef
↵
1. El-Haggar S,
2. Nassef S,
3. Gadalla A,
4. Latif A,
5. Mostafa T
(2012) Ultrasonographic parameters of the spermatic veins at the inguinal and scrotal levels in varicocele diagnosis and post-operative repair. Andrologia 44:210–213.
OpenUrl
↵
1. Waalkes R,
2. Manea IF,
3. Nijman JM
(2012) Varicocele in adolescents: a review and guideline for the daily practice. Arch Esp Urol 65:859–871.
OpenUrl PubMed
1. Fukuda T,
2. Miyake H,
3. Enatsu N,
4. Matsushita K,
5. Fujisawa M
(2015) Assessment of time-dependent changes in semen parameters in infertile men after microsurgical varicocelectomy. Urology 86:48–51.
OpenUrl
1. McGarry P,
2. Alrabeeah K,
3. Jarvi K,
4. Zini A
(2015) Is varicocelectomy beneficial in men previously deemed subfertile but with normal semen parameters based on the new guidelines? A retrospective study. Urology 85:357–362.
OpenUrl
↵
1. Salzhauer EW,
2. Sokol A,
3. Glassberg KI
(2004) Paternity after adolescent varicocele repair. Pediatrics 114:1631–1633.
OpenUrl Abstract/FREE Full Text
↵
1. Shabana W,
2. Teleb M,
3. Dawod T,
4. Elsayed E,
5. Desoky E,
6. Shahin A,
7. Eladl M,
8. Sorour W
(2015) Predictors of improvement in semen parameters after varicocelectomy for male subfertility: A prospective study. Can Urol Assoc J 9:579–582.
OpenUrl
1. Fiogbe MA,
2. Alao MJ,
3. Biaou O,
4. Gbenou SR,
5. Yekpe P,
6. Sossou R,
7. Metchihoungbe SC
(2013) Ultrasound diagnosis of varicocele in the adolescent: our experience from Benin. Afr J Paediatr Surg 10:295–298.
OpenUrl
↵
1. Semiz I,
2. Tokgöz O,
3. Tokgoz H,
4. Voyvoda N,
5. Serifoglu I,
6. Erdem Z
(2014) The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele. Ultrasound Q 30:33–40.
OpenUrl
↵
1. Liguori G,
2. Trombetta C,
3. Garaffa G,
4. Bucci S,
5. Gattuccio I,
6. Salamè L,
7. Belgrano E
(2004) Color Doppler ultrasound investigation of varicocele. World J Urol 22:378–381.
OpenUrl CrossRef PubMed Web of Science
↵
1. Vanlangenhove P,
2. Dhondt E,
3. Everaert K,
4. Defreyne L
(2014) Pathophysiology, diagnosis and treatment of varicoceles: a review. Minerva Urol Nefrol 66:257–282.
OpenUrl
↵
1. Camoglio FS,
2. Zampieri N
(July, 2015) Varicocele treatment in paediatric age: relationship between type of vein reflux, surgical technique used and outcomes. Andrologia, doi: 10.1111/and.12458.
↵
1. Mohseni MJ,
2. Nazari H,
3. Amini E,
4. Javan-Farazmand N,
5. Baghayee A,
6. Farzi H,
7. Kajbafzadeh AM
(2011) Shunt-type and stop-type varicocele in adolescents: prognostic value of these two different hemodynamic patterns. Fertil Steril 96:1091–1096.
OpenUrl PubMed
↵
1. Butler C,
2. Ellsworth P
(2014) Contemporary approach to diagnosis, management, and treatment of varicocele in the adolescent. Urol Nurs 34:271–280.
OpenUrl
↵
1. Baazeem A,
2. Belzile E,
3. Ciampi A,
4. Dohle G,
5. Jarvi K,
6. Salonia A,
7. Weidner W,
8. Zini A
(2011) Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol 60:796–808.
OpenUrl CrossRef PubMed
1. Weidner W,
2. Diemer T
(2008) Reassessing the value of varicocelectomy as a treatment for male subfertility with a new meta-analysis. Eur Urol 54:465–466.
OpenUrl PubMed
1. Cantoro U,
2. Polito M,
3. Muzzonigro G
(2015) Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology 85:826–830.
OpenUrl
↵
1. Lee YJ,
2. Cho SY,
3. Paick JS,
4. Kim SW
(2015) Usefulness of 2010 world health organization reference values for determining indications for varicocelectomy. Urology 85:831–835.
OpenUrl
↵
1. Butler C,
2. Ellsworth P
(2014) Contemporary approach to diagnosis, management, and treatment of varicocele in the adolescent. Urol Nurs 34:271–280.
OpenUrl
↵
1. Sorokin I,
2. Welliver C,
3. Elebyjian L,
4. Feustel PJ,
5. McCullough A
(2015) Interinstitutional variability in testicular volumes and varicocele presence by ultrasound: surprising discrepancies and implications for clinical decision making. Urology 85:1079–1084.
OpenUrl
↵
1. Mehraban D,
2. Taghdiri M,
3. Nategh S,
4. Ahmadzadeh A,
5. Ranjbarnovin N,
6. Hashemi Taheri AP
(2012) Ultrasonic predictors of improved seminal parameters after bilateral laparoscopic varicocelectomy. Int Urol Nephrol 44:1121–1125.
OpenUrl PubMed
1. Babaei Jandaghi A,
2. Moradi H,
3. Hamidi Madani A,
4. Nasseh H,
5. Keshavarz Zirak A,
6. Pourghorban R
(2014) Real-time scrotal ultrasound of patients with varicoceles: correlation with impaired semen analysis. Eur Radiol 24:2245–2251.
OpenUrl
↵
1. Semiz I,
2. Tokgöz O,
3. Tokgoz H,
4. Voyvoda N,
5. Serifoglu I,
6. Erdem Z
(2014) The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele. Ultrasound Q 30:33–40.
OpenUrl
↵
1. Evers JL,
2. Collins JA
(2003) Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 361:1849–1852.
OpenUrl CrossRef PubMed Web of Science
↵
1. Donkol RH,
2. Salem T
(2007) Paternity after varicocelectomy: preoperative sonographic parameters of success. J Ultrasound Med 26:593–599.
OpenUrl Abstract/FREE Full Text
↵
1. Kiuchi H,
2. Koga M,
3. Hirai T,
4. Namba Y,
5. Takeyama M,
6. Nishimura K,
7. et al.
(2005) [Predictive factors associated with successful varicocele repair a study of 139 infertile men with varicocele]. The Japanese Journal of Urology 96:480–486, Japanese.
OpenUrl
↵
1. Mahmoud Abd El-Azez Dawoud,
2. Khaled Abd El-Wahab Abo-Dewan,
3. Mohamed Mohamed Hefeda
(2014) Preoperative sonographic and Doppler parameters predictors of semen analysis improvement after unilateral varicocelectomy. The Egyptian Journal of Radiology and Nuclear Medicine 1:583–589.
OpenUrl

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[1] ↵
Unlu M,
Orguc S,
Serter S,
Pekindil G,
Pabuscu Y
(2007) Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome. Scand J Urol Nephrol 4:42–46.
OpenUrl

[2] Unlu M,

[3] Orguc S,

[4] Serter S,

[5] Pekindil G,

[6] Pabuscu Y

[7] ↵
Iannicelli E,
Sessa B,
Sapori A,
Cappucci M,
Briani C,
Federici GF,
Di Pietropaolo M,
Merola S
(2013) [Scrotal ultrasound: anatomy and pathological findings]. Clin Ter 16:63–75, Italian.
OpenUrl

[8] Iannicelli E,

[9] Sessa B,

[10] Sapori A,

[11] Cappucci M,

[12] Briani C,

[13] Federici GF,

[14] Di Pietropaolo M,

[15] Merola S

[16] ↵
Pajovic B,
Dimitrovski A,
Radojevic N,
Vukovic M
(2015) Comparison of sperm parameters in patients with infertility induced by genital infection versus varicocele. Balkan Med J 32:255–259.
OpenUrl

[17] Pajovic B,

[18] Dimitrovski A,

[19] Radojevic N,

[20] Vukovic M

[21] Huk J,
Fryczkowski M,
Kaletka Z,
Szwedkowski M
(2006) Comparison of testicular volume before and after laparoscopic varicocelectomy in children and adolescents. Med Wieku Rozwoj 10:885–891.
OpenUrl PubMed

[22] Huk J,

[23] Fryczkowski M,

[24] Kaletka Z,

[25] Szwedkowski M

[26] ↵
Baazeem A,
Belzile E,
Ciampi A,
Dohle G,
Jarvi K,
Salonia A,
Weidner W,
Zini A
(2011) Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol 6:796–808.
OpenUrl

[27] Baazeem A,

[28] Belzile E,

[29] Ciampi A,

[30] Dohle G,

[31] Jarvi K,

[32] Salonia A,

[33] Weidner W,

[34] Zini A

[35] ↵
Babaei Jandaghi A,
Moradi H,
Hamidi Madani A,
Nasseh H,
Keshavarz Zirak A,
Pourghorban R
(2014) Real-time scrotal ultrasound of patients with varicoceles: correlation with impaired semen analysis. Eur Radiol 24:2245–2251.
OpenUrl

[36] Babaei Jandaghi A,

[37] Moradi H,

[38] Hamidi Madani A,

[39] Nasseh H,

[40] Keshavarz Zirak A,

[41] Pourghorban R

[42] ↵
Pilatz A,
Altinkilic B,
Köhler E,
Marconi M,
Weidner W
(2011) Color doppler ultrasound imaging in varicoceles: is the venous diameter sufficient for predicting clinical and subclinical varicocele? World J Urol 29:645–650.
OpenUrl CrossRef PubMed

[43] Pilatz A,

[44] Altinkilic B,

[45] Köhler E,

[46] Marconi M,

[47] Weidner W

[48] ↵
Kim YS,
Kim SK,
Cho IC,
Min SK
(2015) Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis. Korean J Urol 56:144–147.
OpenUrl

[49] Kim YS,

[50] Kim SK,

[51] Cho IC,

[52] Min SK

[53] Liguori G,
Trombetta C,
Garaffa G,
Bucci S,
Gattuccio I,
Salamè L,
Belgrano E
(2004) Color Doppler ultrasound investigation of varicocele. World J Urol 22:378–381.
OpenUrl CrossRef PubMed Web of Science

[54] Liguori G,

[55] Trombetta C,

[56] Garaffa G,

[57] Bucci S,

[58] Gattuccio I,

[59] Salamè L,

[60] Belgrano E

[61] Schurich M,
Aigner F,
Frauscher F,
Pallwein L
(2009) The role of ultrasound in assessment of male fertility. Eur J Obstet Gynecol Reprod Biol 144:192–198.
OpenUrl CrossRef

[62] Schurich M,

[63] Aigner F,

[64] Frauscher F,

[65] Pallwein L

[66] ↵
El-Haggar S,
Nassef S,
Gadalla A,
Latif A,
Mostafa T
(2012) Ultrasonographic parameters of the spermatic veins at the inguinal and scrotal levels in varicocele diagnosis and post-operative repair. Andrologia 44:210–213.
OpenUrl

[67] El-Haggar S,

[68] Nassef S,

[69] Gadalla A,

[70] Latif A,

[71] Mostafa T

[72] ↵
Waalkes R,
Manea IF,
Nijman JM
(2012) Varicocele in adolescents: a review and guideline for the daily practice. Arch Esp Urol 65:859–871.
OpenUrl PubMed

[73] Waalkes R,

[74] Manea IF,

[75] Nijman JM

[76] Fukuda T,
Miyake H,
Enatsu N,
Matsushita K,
Fujisawa M
(2015) Assessment of time-dependent changes in semen parameters in infertile men after microsurgical varicocelectomy. Urology 86:48–51.
OpenUrl

[77] Fukuda T,

[78] Miyake H,

[79] Enatsu N,

[80] Matsushita K,

[81] Fujisawa M

[82] McGarry P,
Alrabeeah K,
Jarvi K,
Zini A
(2015) Is varicocelectomy beneficial in men previously deemed subfertile but with normal semen parameters based on the new guidelines? A retrospective study. Urology 85:357–362.
OpenUrl

[83] McGarry P,

[84] Alrabeeah K,

[85] Jarvi K,

[86] Zini A

[87] ↵
Salzhauer EW,
Sokol A,
Glassberg KI
(2004) Paternity after adolescent varicocele repair. Pediatrics 114:1631–1633.
OpenUrl Abstract/FREE Full Text

[88] Salzhauer EW,

[89] Sokol A,

[90] Glassberg KI

[91] ↵
Shabana W,
Teleb M,
Dawod T,
Elsayed E,
Desoky E,
Shahin A,
Eladl M,
Sorour W
(2015) Predictors of improvement in semen parameters after varicocelectomy for male subfertility: A prospective study. Can Urol Assoc J 9:579–582.
OpenUrl

[92] Shabana W,

[93] Teleb M,

[94] Dawod T,

[95] Elsayed E,

[96] Desoky E,

[97] Shahin A,

[98] Eladl M,

[99] Sorour W

[100] Fiogbe MA,
Alao MJ,
Biaou O,
Gbenou SR,
Yekpe P,
Sossou R,
Metchihoungbe SC
(2013) Ultrasound diagnosis of varicocele in the adolescent: our experience from Benin. Afr J Paediatr Surg 10:295–298.
OpenUrl

[101] Fiogbe MA,

[102] Alao MJ,

[103] Biaou O,

[104] Gbenou SR,

[105] Yekpe P,

[106] Sossou R,

[107] Metchihoungbe SC

[108] ↵
Semiz I,
Tokgöz O,
Tokgoz H,
Voyvoda N,
Serifoglu I,
Erdem Z
(2014) The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele. Ultrasound Q 30:33–40.
OpenUrl

[109] Semiz I,

[110] Tokgöz O,

[111] Tokgoz H,

[112] Voyvoda N,

[113] Serifoglu I,

[114] Erdem Z

[115] ↵
Liguori G,
Trombetta C,
Garaffa G,
Bucci S,
Gattuccio I,
Salamè L,
Belgrano E
(2004) Color Doppler ultrasound investigation of varicocele. World J Urol 22:378–381.
OpenUrl CrossRef PubMed Web of Science

[116] Liguori G,

[117] Trombetta C,

[118] Garaffa G,

[119] Bucci S,

[120] Gattuccio I,

[121] Salamè L,

[122] Belgrano E

[123] ↵
Vanlangenhove P,
Dhondt E,
Everaert K,
Defreyne L
(2014) Pathophysiology, diagnosis and treatment of varicoceles: a review. Minerva Urol Nefrol 66:257–282.
OpenUrl

[124] Vanlangenhove P,

[125] Dhondt E,

[126] Everaert K,

[127] Defreyne L

[128] ↵
Camoglio FS,
Zampieri N
(July, 2015) Varicocele treatment in paediatric age: relationship between type of vein reflux, surgical technique used and outcomes. Andrologia, doi: 10.1111/and.12458.

[129] Camoglio FS,

[130] Zampieri N

[131] ↵
Mohseni MJ,
Nazari H,
Amini E,
Javan-Farazmand N,
Baghayee A,
Farzi H,
Kajbafzadeh AM
(2011) Shunt-type and stop-type varicocele in adolescents: prognostic value of these two different hemodynamic patterns. Fertil Steril 96:1091–1096.
OpenUrl PubMed

[132] Mohseni MJ,

[133] Nazari H,

[134] Amini E,

[135] Javan-Farazmand N,

[136] Baghayee A,

[137] Farzi H,

[138] Kajbafzadeh AM

[139] ↵
Butler C,
Ellsworth P
(2014) Contemporary approach to diagnosis, management, and treatment of varicocele in the adolescent. Urol Nurs 34:271–280.
OpenUrl

[140] Butler C,

[141] Ellsworth P

[142] ↵
Baazeem A,
Belzile E,
Ciampi A,
Dohle G,
Jarvi K,
Salonia A,
Weidner W,
Zini A
(2011) Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol 60:796–808.
OpenUrl CrossRef PubMed

[143] Baazeem A,

[144] Belzile E,

[145] Ciampi A,

[146] Dohle G,

[147] Jarvi K,

[148] Salonia A,

[149] Weidner W,

[150] Zini A

[151] Weidner W,
Diemer T
(2008) Reassessing the value of varicocelectomy as a treatment for male subfertility with a new meta-analysis. Eur Urol 54:465–466.
OpenUrl PubMed

[152] Weidner W,

[153] Diemer T

[154] Cantoro U,
Polito M,
Muzzonigro G
(2015) Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Urology 85:826–830.
OpenUrl

[155] Cantoro U,

[156] Polito M,

[157] Muzzonigro G

[158] ↵
Lee YJ,
Cho SY,
Paick JS,
Kim SW
(2015) Usefulness of 2010 world health organization reference values for determining indications for varicocelectomy. Urology 85:831–835.
OpenUrl

[159] Lee YJ,

[160] Cho SY,

[161] Paick JS,

[162] Kim SW

[163] ↵
Butler C,
Ellsworth P
(2014) Contemporary approach to diagnosis, management, and treatment of varicocele in the adolescent. Urol Nurs 34:271–280.
OpenUrl

[164] Butler C,

[165] Ellsworth P

[166] ↵
Sorokin I,
Welliver C,
Elebyjian L,
Feustel PJ,
McCullough A
(2015) Interinstitutional variability in testicular volumes and varicocele presence by ultrasound: surprising discrepancies and implications for clinical decision making. Urology 85:1079–1084.
OpenUrl

[167] Sorokin I,

[168] Welliver C,

[169] Elebyjian L,

[170] Feustel PJ,

[171] McCullough A

[172] ↵
Mehraban D,
Taghdiri M,
Nategh S,
Ahmadzadeh A,
Ranjbarnovin N,
Hashemi Taheri AP
(2012) Ultrasonic predictors of improved seminal parameters after bilateral laparoscopic varicocelectomy. Int Urol Nephrol 44:1121–1125.
OpenUrl PubMed

[173] Mehraban D,

[174] Taghdiri M,

[175] Nategh S,

[176] Ahmadzadeh A,

[177] Ranjbarnovin N,

[178] Hashemi Taheri AP

[179] Babaei Jandaghi A,
Moradi H,
Hamidi Madani A,
Nasseh H,
Keshavarz Zirak A,
Pourghorban R
(2014) Real-time scrotal ultrasound of patients with varicoceles: correlation with impaired semen analysis. Eur Radiol 24:2245–2251.
OpenUrl

[180] Babaei Jandaghi A,

[181] Moradi H,

[182] Hamidi Madani A,

[183] Nasseh H,

[184] Keshavarz Zirak A,

[185] Pourghorban R

[186] ↵
Semiz I,
Tokgöz O,
Tokgoz H,
Voyvoda N,
Serifoglu I,
Erdem Z
(2014) The investigation of correlation between semen analysis parameters and intraparenchymal testicular spectral Doppler indices in patients with clinical varicocele. Ultrasound Q 30:33–40.
OpenUrl

[187] Semiz I,

[188] Tokgöz O,

[189] Tokgoz H,

[190] Voyvoda N,

[191] Serifoglu I,

[192] Erdem Z

[193] ↵
Evers JL,
Collins JA
(2003) Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 361:1849–1852.
OpenUrl CrossRef PubMed Web of Science

[194] Evers JL,

[195] Collins JA

[196] ↵
Donkol RH,
Salem T
(2007) Paternity after varicocelectomy: preoperative sonographic parameters of success. J Ultrasound Med 26:593–599.
OpenUrl Abstract/FREE Full Text

[197] Donkol RH,

[198] Salem T

[199] ↵
Kiuchi H,
Koga M,
Hirai T,
Namba Y,
Takeyama M,
Nishimura K,
et al.
(2005) [Predictive factors associated with successful varicocele repair a study of 139 infertile men with varicocele]. The Japanese Journal of Urology 96:480–486, Japanese.
OpenUrl

[200] Kiuchi H,

[201] Koga M,

[202] Hirai T,

[203] Namba Y,

[204] Takeyama M,

[205] Nishimura K,

[206] et al.

[207] ↵
Mahmoud Abd El-Azez Dawoud,
Khaled Abd El-Wahab Abo-Dewan,
Mohamed Mohamed Hefeda
(2014) Preoperative sonographic and Doppler parameters predictors of semen analysis improvement after unilateral varicocelectomy. The Egyptian Journal of Radiology and Nuclear Medicine 1:583–589.
OpenUrl

[208] Mahmoud Abd El-Azez Dawoud,

[209] Khaled Abd El-Wahab Abo-Dewan,

[210] Mohamed Mohamed Hefeda

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