Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data

Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129–0.278; p<0.001; I2=83.62%, Egger’s p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474–1.706; p<0.001; I2=97.86%, Egger’s p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526–2.121; p<0.001; I2=97.88%, Egger’s p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318–1.968; p<0.001; I2=98.65%, Egger’s p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%–2.153%; p<0.001; I2=98.97%, Egger’s p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%–1.759%; p<0.001; l2=97.98%, Egger’s p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%–1.211%; p<0.001; I2=97.87%, Egger’s p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele. Keywords Controlled before-after studies; Infertility, male; Meta-analysis; Varicocel

Trends in selective abortions of girls in India: analysis of nationally representative birth histories from 1990 to 2005 and census data from 1991 to 2011.

BACKGROUND: India's 2011 census revealed a growing imbalance between the numbers of girls and boys aged 0-6 years, which we postulate is due to increased prenatal sex determination with subsequent selective abortion of female fetuses. We aimed to establish the trends in sex ratio by birth order from 1990 to 2005 with three nationally representative surveys and to quantify the totals of selective abortions of girls with census cohort data. METHODS: We assessed sex ratios by birth order in 0·25 million births in three rounds of the nationally representative National Family Health Survey covering the period from 1990 to 2005. We estimated totals of selective abortion of girls by assessing the birth cohorts of children aged 0-6 years in the 1991, 2001, and 2011 censuses. Our main statistic was the conditional sex ratio of second-order births after a firstborn girl and we used 3-year rolling weighted averages to test for trends, with differences between trends compared by linear regression. FINDINGS: The conditional sex ratio for second-order births when the firstborn was a girl fell from 906 per 1000 boys (99% CI 798-1013) in 1990 to 836 (733-939) in 2005; an annual decline of 0·52% (p for trend=0·002). Declines were much greater in mothers with 10 or more years of education than in mothers with no education, and in wealthier households compared with poorer households. By contrast, we did not detect any significant declines in the sex ratio for second-order births if the firstborn was a boy, or for firstborns. Between the 2001 and 2011 censuses, more than twice the number of Indian districts (local administrative areas) showed declines in the child sex ratio as districts with no change or increases. After adjusting for excess mortality rates in girls, our estimates of number of selective abortions of girls rose from 0-2·0 million in the 1980s, to 1·2-4·1 million in the 1990s, and to 3·1-6·0 million in the 2000s. Each 1% decline in child sex ratio at ages 0-6 years implied 1·2-3·6 million more selective abortions of girls. Selective abortions of girls totalled about 4·2-12·1 million from 1980-2010, with a greater rate of increase in the 1990s than in the 2000s. INTERPRETATION: Selective abortion of girls, especially for pregnancies after a firstborn girl, has increased substantially in India. Most of India's population now live in states where selective abortion of girls is common. FUNDING: US National Institutes of Health, Canadian Institute of Health Research, International Development Research Centre, and Li Ka Shing Knowledge Institute

Starch based hydrogel with potential biomedical application as artificial skin

The wound is a biosynthetic environment in which numerous cellular processes are interlinked in the process of repair. Modern dressings are designed to facilitate wound healing rather than just to cover it. Hydrogel dressing can protect injured skin and keep it appropriately moist to speed the healing process by absorbing exudates while maintaining the products of tissue repair, including growth factor and lysosomes, in contact with the wound. The design and development of novel membrane of hydrogel prepared by crosslinking of polyvinyl alcohol with starch suspension using glutaraldehyde as a crosslinking agent was attempted. The membrane was characterized by FTIR spectroscopy. The mechanical property of the hydrogel membrane was characterized by tensile tests. The diffusion coefficient of salicylic acid through the membrane was also evaluated. FTIR spectra of the membrane indicated the absence of free aldehydic groups of glutaraldehyde. The membranes had sufficient strength. The diffusion coefficient of the analgesic drug salicylic acid, used as a model drug, in the prepared starch hydrogels has been measured using a diaphragm cell technique. At 30 °C, the measured value of the diffusion coefficient was approximately 5.03×10-14 m2/s

Improved conversion to ethyl acetate through removal of water of esterification by membrane pervaporation

552-559Crosslinked poly (vinyl alcohol) (PVA) membranes were prepared using maleic acid (MA) and citric acid (CA) as crosslinking agents. First the water separation ability of the crosslinked membranes from aqueous acetic acid (10-90% acetic acid) and ethanol (20-80% ethanol) solutions at 30 to 90ºC was tested by pervaporation. The effects of temperature, feed concentration, crosslinker type on pervaporation characteristics were investigated. The PVAMA membrane showed separation factors of 1.9-16.2 and fluxes of 4.26-38.48 kg/m² h and PVACA membrane showed separation factors of 3.8-33 and fluxes of 2.17-480.8 kg/m² h for acetic acid-water separation. In case of ethanol-water separation, the PVAMA membrane showed separation factors of 0.7-17.9 and fluxes of 2.5-36.2 kg/m² h and PVACA membrane showed separation factors of 1.4-41.9 and fluxes of 3.8-359.7 kg/m² h. PVACA membrane has shown high separation efficiency of water than that of PVAMA membrane. Having high selectivity and good permeating ability for water both the membranes were then used to remove water of esterification from reaction of acetic acid with ethanol by a batch pervaporation. Compared to around 60% conversion in conventional esterification, up to 98% conversion to ethyl acetate was achieved from ethanol and acetic acid when water by product was removed by pervaporation using the prepared membranes at same temperature