DNA fragmentation index and its correlation with other sperm parameters in 4833 infertile males

Background: Semen analysis forms the basic investigation for male factor of infertility. According to WHO Manual sperm values of normalcy are decreasing. Recent studies have highlighted newer parameters of sperm playing their role in the outcome of pregnancy. The aim was to study the DNA fragmentation index (DFI) and to know its correlation with other sperm parameters.Methods: A total of 4833 cases underwent routine semen analysis along with the DFI. The statistical analysis was done using SPSS using t test and ANOVA test.Results: It was observed that 52% infertile males presented late for treatment. All parameters showed a decline with advancing age. There was definite correlation between sperm count and sperm motility as well as morphology. The DFI showed significant negative correlation with sperm count. Pearson correlation showed positive correlation between DFI and sperm motility and morphology.Conclusions: The study highlights the need for increasing awareness about male factor of infertility. A thorough semen analysis along with DFI can help the clinician to explain the couple in a better way about the choice of ART and success of treatment

Uterine arteriovenous malformation

Uterine arteriovenous malformation (AVM) is a rare condition. It can become life threatening due to the profuse bleeding with which patients may present. This case report presents a case of a 40-year-old lady who presented with repeated episodes of bleeding per vaginum after a dilatation and evacuation for an induced abortion. Ultrasound along with Doppler showed AVM in the anterior body of the uterus which was eventually confirmed by Magnetic Resonance Imaging. With no desire to preserve future fertility, our patient underwent a laparoscopic assisted vaginal hysterectomy successfully. The diagnosis was confirmed on histopathology

Kozmološka rješenja teorije gravitacije s promjenljivom masom mirovanja

We have obtained cosmological solutions in five-dimensional space-time-mass theory of gravitation by assuming components of energy momentum tensor, pressure p=0 and the role of p4 as a cosmological constant. The behaviour of the solution is discussed for the cases in which k=-1,0,+1.Izveli smo kozmološka rješenja u petdimenzijskoj prostor-vrijeme-masa teoriji gravitacije pretpostavljajući komponente tenzora energije-impulsa, tlak p = 0, te uzevši p4 u ulozi kozmološke konstante. Raspravljamo značajke rješenja za k = +1, 0, −1

Speman®, A Proprietary Ayurvedic Formulation, Reverses Cyclophosphamide-Induced Oligospermia In Rats.

Background: This investigation was aimed to evaluate the effect of Speman®, a well known ayurvedic proprietary preparation, in an experimental model of cyclophosphamide-(CP) induced oligospermia in rats.Materials and Methods: Thirty male rats were randomized in to five, equally-sized groups. Rats in group 1 served as a normal control; group 2 served as an untreated positive control; groups 3, 4, 5 received  Speman® granules  at doses of 300, 600, and 900mg/kg body weight p.o. respectively, once daily for 13 days. On day four, one hour after the respective treatment, oligospermia was induced by administering a single dose of CP (100mg/kg body weight p.o.)  to all the groups except group1. At the end of the study period the rats were euthanised and accessory reproductive organs were weighed and subjected to histopathological examination. The semen samples were subject to enumeration of sperms.  Weight of the reproductive organs, histopathological examination of the tissues, and sperm count were the parameters studied to understand the effect of Speman® on rats with CP-induced oligospermia.Results: Changes that occurred due to the administration of CP at a dose of 100 mg/kg body weight were dose dependently reversed with Speman® at a dose of 300, 600, and 900 mg/kg body weight. There was a statistically significant increase in sperm count and the weight of the seminal vesicle, epididymis, and prostate.Conclusion: Findings of this investigation indicate that Speman® dose dependently reversed the CP-induced derangement of various parameters pertaining to the reproductive system.  This could explain the total beneficial actions of Speman® reported in several other clinical trials

Preterm birth among pregnancies conceived by assisted reproduction techniques in Mumbai, Maharashtra, India

Background: Preterm births are an enormous global problem on families, medical system and economy. The rates of preterm birth are increasing and one of the contributors is growing use of Assisted Reproduction Techniques (ART) leading to multifetal gestations. Some risk factors for preterm birth are specific to women who conceive by ART. Since there is limited data from India, this pilot study was undertaken to assess the magnitude of preterm birth among pregnancies conceived by ART and to study the contributing factors.Methods: Clinic based descriptive cohort study through eight ART clinics in Mumbai for one year. Data was collected using an in-depth questionnaire on socio-demographic characteristics, medical history, ART details, course and complications during pregnancy, mode of delivery, pregnancy outcome, risk factors related to preterm birth and neonatal outcome. Complete details of 113 participants who completed the study were analyzed.Results: Study showed high incidence of preterm birth (76.23%) among women conceived with ART. Multiple gestations were observed in 45.1%. Pregnancy related complications like heterotrophic pregnancy (3%), pre eclampsia (15%) and gestational diabetes (11%) were high. Incidence of caesarean section was very high (98%). Neonatal outcome was good with 98% live births and only 2 still births.Conclusions: Present study highlights that preterm birth, multiple pregnancies, pregnancy related complications like preeclampsia, gestational diabetes and caesarean sections are very high among women conceived by ART. With growing use of ART there is an urgent need to develop a National ART Surveillance system in India like the one in Centre for Disease Control Atlanta to get complete data on the pregnancy course and outcomes of ART conceptions. Efforts to limit the number of embryos transferred should be strengthened to prevent multiple births

A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population?

Context: Prostate cancer (PC) disproportionately affects men of Black race, and lower educational and socioeconomic status. Guidelines are based on randomised controlled trials (RCTs); however, the representation of different races, educations, and socioeconomic backgrounds in these trials is unclear. Objective: To assess reporting of equality, diversity, and inclusion characteristics (Equality, Diversity and Inclusion [EDI]) and differences in treatment effects between different races, and educational or socioeconomic status. Evidence acquisition: We conducted a systematic review of CENTRAL, MEDLINE, and Embase in April 2020 examining RCTs investigating treatments for PC. Outcomes collected were race/ethnicity, educational attainment, and socioeconomic status. RCTs investigating PC treatment in any population or setting were included. Data extraction of characteristics was performed independently by pairs of reviewers and checked by a senior author. The Cochrane risk of bias tool assessed the quality of included papers. Evidence synthesis: A total of 265 trials were included, and 138 of these were available as full-text articles. Fifty-four trials including 19 039 participants reported any EDI data. All 54 trials reported race, 11 reported ethnicity, three reported educational attainment, and one reported socioeconomic status. Patients of White race were the majority of the recruited population (82.6%), while the minority prevalence was as follows: Black 9.8% and Asian 5.7%. Three studies reported mortality outcomes depending on the participant's race. All three studies investigated different treatments, so a meta-analysis was not performed. No studies reported outcomes stratified by the educational or socioeconomic status of participants. Conclusions: There is poor reporting of patient race, ethnicity, socioeconomic background, and educational attainment in RCTs for PC treatments between 2010 and 2020. Addressing this for future studies will help explain differences in the incidence of and mortality from PC and improve the generalisability of results. Patient summary: In this study, we reviewed prostate cancer treatment trials to see whether these reported race, education, and socioeconomic backgrounds of their patient populations. We conclude that reporting of these characteristics is poor. This needs to be improved in future to improve outcomes for patients with prostate cancer of all ethnical, racial, and socioeconomic groups