The role of seminal oxidative stress in recurrent pregnancy loss

Recurrent pregnancy loss is a distressing condition affecting 1-2% of couples. Traditionally investigations have focused on the female, however more recently researchers have started to explore the potential contribution of the male partner. Seminal reactive oxygen species have a physiological function in male reproduction but in excess are suspected to generate structural and functional damage to the sperm. Evidence is mounting to support an association between elevated seminal reaction oxygen species and recurrent pregnancy loss. Studies suggest that the rates of sperm DNA damage are higher in the male partners of women affected by recurrent pregnancy loss compared with unaffected men. However, the available pool of data is conflicting, and interpretation is limited by the recent change in nomenclature and the heterogeneity of study methodologies. Furthermore, investigation into the effects of oxidative stress on the epigenome show promise. The value of antioxidant therapy in the management of recurrent pregnancy loss currently remains unclear

Understanding and treating ejaculatory dysfunction in men with Diabetes mellitus

INTRODUCTION: Diabetes mellitus (DM) is a rapidly rising metabolic disorder with important systemic complications. Global figures have demonstrated the prevalence of DM has almost quadrupled from 108 million in 1980 to 422 million in 2014, with a current prevalence of over 525 million. Of the male sexual dysfunction resulting from DM, significant focus is afforded to erectile dysfunction (ED). Nevertheless, ejaculatory dysfunction (EjD) constitutes important sexual sequelae in diabetic men, with up to 35-50% of men with DM suffering from EjD. Despite this, aspects of its pathophysiology and treatment are less well understood than ED. The main disorders of ejaculation include premature ejaculation (PE), delayed ejaculation (DE), anejaculation (AE) and retrograde ejaculation (RE). BACKGROUND: Although EjD in DM can have complex multifactorial aetiology, understanding the pathophysiological mechanisms caused by DM has facilitated the development of therapies in the management of EjD. Most of our understanding of its pathophysiology is derived from diabetic animal models, however observational studies in humans have also provided useful information in elucidating important associative factors potentially contributing to EjD in diabetic men. These have provided the potential for more tailored treatment regimens in patients depending on the ejaculatory disorder, other co-existing sequelae of DM, specific metabolic factors as well as the need for fertility treatment. However, the evidence for treatment of EjD, especially DE and RE, is based on low-level evidence comprising small sample-size series and retrospective or cross-sectional studies. Whilst promising findings from large randomised controlled trials (RCTs) have provided strong evidence for the licensed treatment of PE, similar robust studies are needed to accurately elucidate factors predicting EjD in DM, as well as for the development of pharmacotherapies for DE and RE. Similarly, more contemporary robust data is required for fertility outcomes in these patients, including methods of sperm retrieval and assisted reproductive techniques (ART) in RE. This article is protected by copyright. All rights reserved

Intrathecal clonidine for post-operative pain relief in lower abdominal surgeries

Background: Spinal anaesthesia is preferred method for surgeries of lower half of the body due to its efficacy, rapidity, minimal side effects. Generally bupivacaine is given as an spinal anaesthetic agent because of its  analgesic effect in the initial postoperative period. For additional analgesic effect particularly for lower limb surgeries now-a-days it is recommended to add an adjuvant inj.clonidine. Hence the present study is aimed to compare the effects of combination of clonidine with bupivacaine and bupivacaine alone.   Methods: The study  was prospective, randomized, double blinded and controlled study. 90 indoor patients between age group of 18-70 years of either sex of ASA physical status I/II who were to undergo lower abdominal surgeries including gynaecological, orthopaedic and surgical were selected for the study. Parameters like post operative analgesic effects, onset, peak level and two segment regression of sensory block and onset, peak and recovery of motor block, time of rescue analgesia and  various side effects were assessed on administration of clonidine at a dose 60 mcg intrathecally and 75 mcg of bupivacaine and comparing the same with bupivacaine hydrochloride alone.Results: Of 90 patients, the mean age group of the patients was 34, mean weight was 56 kgs and average height was 106 cm. The number of males was 63 and females were 27. Patients receiving bupivacaine 0.5% and different doses of clonidine 60 mcg and 75 mcg (group B and group C) respectively produced significant sensory and motor blockade, increases in time of rescue analgesic with lesser side effects compared to bupivacaine alone receiving group. When compared group B and group C, group receiving highest dose of clonidine produced good results compared to group B.Conclusions: It is concluded that patients receiving bupavacaine with clonidine at different doses produced significant anaesthetic, analgesic effect and lesser side effects compared to bupavacaine alone receiving group

Giant tonsillolith causing odynophagia in a child: a rare case report

Giant tonsillolith is a rare clinical entity. Commonly, it occurs between 20–77 years of age. We had a twelve years old female patient, who had odynophagia due to a giant tonsillolith. The stone was removed and tonsillectomy was performed. We reviewed the literature on this rare clinical entity and found that this is the fourth case of giant tonsillolith in a child and largest ever tonsillolith to be reported in English literature

Improvements in sperm motility following low or high intensity dietary interventions in men with obesity

Introduction: Obesity increases risks of male infertility, but bariatric surgery does not improve semen quality. Recent uncontrolled studies suggest that a low-energy diet (LED) improves semen quality. Further evaluation within a randomized, controlled setting is warranted. Methods: Men with obesity (18-60 years) with normal sperm concentration (normal count) (n = 24) or oligozoospermia (n = 43) were randomized 1:1 to either 800 kcal/day LED for 16 weeks or control, brief dietary intervention (BDI) with 16 weeks’ observation. Semen parameters were compared at baseline and 16 weeks. Results: Mean age of men with normal count was 39.4 ± 6.4 in BDI and 40.2 ± 9.6 years in the LED group. Mean age of men with oligozoospermia was 39.5 ± 7.5 in BDI and 37.7 ± 6.6 years in the LED group. LED caused more weight loss than BDI in men with normal count (14.4 vs 6.3 kg; P < .001) and men with oligozoospermia (17.6 vs 1.8 kg; P < .001). Compared with baseline, in men with normal count total motility (TM) increased 48 ± 17% to 60 ± 10% (P < .05) after LED, and 52 ± 8% to 61 ± 6% (P < .0001) after BDI; progressive motility (PM) increased 41 ± 16% to 53 ± 10% (P < .05) after LED, and 45 ± 8% to 54 ± 65% (P < .001) after BDI. In men with oligozoospermia compared with baseline, TM increased 35% [26] to 52% [16] (P < .05) after LED, and 43% [28] to 50% [23] (P = .0587) after BDI; PM increased 29% [23] to 46% [18] (P < .05) after LED, and 33% [25] to 44% [25] (P < .05) after BDI. No differences in postintervention TM or PM were observed between LED and BDI groups in men with normal count or oligozoospermia. Conclusion: LED or BDI may be sufficient to improve sperm motility in men with obesity. The effects of paternal dietary intervention on fertility outcomes requires investigation

Moisture Stress Assessment through NDVI and Climate Tools for Crop Management at Anantpur District, AP

Anantapur is the driest district of Andhra Pradesh and hence, agriculture conditions are very often precarious. Groundnut grows where other crops fail and thus it is the predominant crop of Anantapur district. Groundnut is grown in about 7.5 lakh ha in Anantapur district; however the average yields are low af 500 kg ha-1. Among various available vegetation indices, normalised difference vegetation index (ND VI) is widely used for all reasons, which is a single numerical indicator of presence and condition of green vegetation. ND VI mapping at a regional scale helps to assess the spatial changes in the vigour of green vegetation and thus occurrence of any moisture stress. Climate tOQls have a great role in understanding the crop performance and estimating the yields. This study was taken up by using freely available MODIS data to understand ND VI in terms of abiotic stresses over Anantapur district and linking with the actual rainfall conditions, groundnut crop acreage and production. Results indicate that low groundnut yields in general,could be related to ND VI-based stress measurements and rainfall quantum and distribution in the area however, with a few exceptions. It is hoped that by combining improved practices through IWM with climate-adapted crop varieties, rainfed farmers of Anantapur district can sustain their crop production under present climate variability and become resilient to future climate chang