Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm’s potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Ultrasonography as a diagnostic tool in orofacial swellings

Introduction: For several years, ultrasonography has played a major role as a diagnostic and therapeutic tool in various medical fields. Only recently has it been used for maxillofacial imaging. Aims and Objectives: To evaluate the reliability of ultrasonography as an alternative tool in the diagnosis of swellings in the orofacial region. Materials and Methods: Ultrasonographic examination of 30 patients of both the sexes aged between 8 and 70 years with swelling in the orofacial region was conducted. Doppler investigation was done in some cases to evaluate the vascularity. The following six sonographic parameters were recorded: shape, boundary echo, internal echo, distribution of internal echoes, posterior wall echoes, and vascularity. Following the clinical and ultrasonographic diagnosis, the lesion was subjected to histopathological examination and a final diagnosis was made. The ultrasonographic diagnosis was correlated with the clinical and histopathological diagnosis. Results: A significant association was observed between both clinical and histopathological diagnosis and ultrasonographic diagnosis (contingency = 0.888, P value = 0.000). Conclusion: Along with clinical and histopathological examinations, ultrasonography works out as a valuable adjunct in the diagnosis of orofacial swellings as it provides several advantages like it is non-invasive, easily reproducible, widely available, rapid, and inexpensive

Ultrasonography as a diagnostic tool in orofacial swellings

Introduction: For several years, ultrasonography has played a major role as a diagnostic and therapeutic tool in various medical fields. Only recently has it been used for maxillofacial imaging. Aims and Objectives: To evaluate the reliability of ultrasonography as an alternative tool in the diagnosis of swellings in the orofacial region. Materials and Methods: Ultrasonographic examination of 30 patients of both the sexes aged between 8 and 70 years with swelling in the orofacial region was conducted. Doppler investigation was done in some cases to evaluate the vascularity. The following six sonographic parameters were recorded: shape, boundary echo, internal echo, distribution of internal echoes, posterior wall echoes, and vascularity. Following the clinical and ultrasonographic diagnosis, the lesion was subjected to histopathological examination and a final diagnosis was made. The ultrasonographic diagnosis was correlated with the clinical and histopathological diagnosis. Results: A significant association was observed between both clinical and histopathological diagnosis and ultrasonographic diagnosis (contingency = 0.888, P value = 0.000). Conclusion: Along with clinical and histopathological examinations, ultrasonography works out as a valuable adjunct in the diagnosis of orofacial swellings as it provides several advantages like it is non-invasive, easily reproducible, widely available, rapid, and inexpensive

Carriage of Class 1 integrons and molecular characterization of intI1 gene in multidrug-resistant Salmonella spp. isolates from broilers

Aim: The present study was conducted with the following aims: (i) To screen the Salmonella spp. isolates recovered from suspected cases of fowl typhoid for carriage of Class 1 integrons and analyze their association with antimicrobial resistance and (ii) to carry out molecular characterization and phylogenetic analysis of Class 1 integron-integrase (intI1) gene. Materials and Methods: A total of 43 Salmonella isolates were subjected to polymerase chain reaction (PCR) assay to determine the presence of Class1 intI1. Differences between different serotypes in relation to their carriage of integrons and the differences between strains containing or not containing an integron and being resistant to different antimicrobials were analyzed by Fisher exact test using STATA™ (StataCorp, College Station, TX). Phylogenetic analysis was carried out using MEGA6 software. Results: Out of 43 isolates, 40 (93.02%) were found positive for Class 1 integrons. 35/40 (87.5%) intI1-positive isolates were multidrug resistance (MDR) (resistant to ≥4 antibiotics), which support the hypothesis of an association between the presence of Class 1 integrons and emerging MDR in Salmonella. There was no significant difference among isolates resistant to different antimicrobials in Class 1 integron carrying isolates and the Class 1 integron negative isolates (p<0.05). Further, there was no significant difference among different serotypes in respect of their carriage of Class 1 integrons. Conclusion: It can be concluded that the high prevalence of Class 1 integrons indicates a high potential of Salmonella isolates for horizontal transmission of antimicrobial genes, especially among Gram-negative organisms

Prevalence of pulmonary tuberculosis among adults in a north Indian district.

Recent population prevalence estimates of pulmonary tuberculosis (PTB) are not available for several areas in India. We conducted a field-based population survey at a north Indian district to estimate point prevalence of bacteriologically positive PTB.A stratified cluster sampling design was used to conduct the survey in both urban and rural areas within the district. All adults aged more than 15 years, in 18 rural and 12 urban clusters of 3000 subjects each, were interviewed using a symptom card. Two sputum samples were collected from all persons having symptoms suggestive of PTB, or history of antitubercular treatment, for smear microscopy for acid-fast bacilli and mycobacterial culture. Those having at least one sputum specimen positive on microscopy and/or culture were categorized as having PTB. Prevalence was estimated after adjusting for cluster sampling and incomplete data (through individual level analysis with robust standard error).Of 91,030 eligible adult participants (47,714 men and 43,316 women), 85,770 (94.2%) completed the symptom cards. Of them, 2,898 persons were considered eligible for sputum examination and 2,839 (98.0%) provided at least one sample. Overall, 21 persons had bacteriologically positive PTB, and cluster level prevalence was estimated at 24.5 per 100,000 population (95% CI 12.8-36.2). Individual level analysis with robust standard error yielded a prevalence estimate of 24.1 per 100,000 populations (95% CI 12.8-35.4).The observed prevalence of bacteriologically positive PTB in this district is lower than empiric national estimates, probably as a result of successful implementation of tuberculosis control measures in the area

Age and gender distribution of study population.

<p>Age and gender distribution of study population.</p