Genetic factors in the clinical management of male infertility

Background: Infertility is a common gynecological problem. Most literatures are about female infertility with emphasis on infection sequelae and other factors such as anovulation. More recent studies reveal significant contribution from the males presenting as severe oligospermia and azoospermia.Objective: This literature reviews the genetic factors that contribute to male infertility, in the form of genic problem in the genes on the Y chromosome (primary) or sequelae of other genetic problems (secondary). They are discussed as pre- and post–spermatogenic. The common ones such as Y-chromosome microdeletions in the azoospermia factor (AZF) locus, Klinifelter syndrome 47XXY and Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations leading to congenital absence of the vas deferens (CAVD) are discussed. Other less common causes include Prader Willi syndrome, Kennedy disease, Katergener syndrome and Polycystic kidney disease.Source: Medline search of local and non local articles, as well as standard text on human genetics were used for the reviewConclusion: Genetic factors play an important role male infertility and knowledge about them forms the basis for the rational management of males with severe oligospermia and azoospermia especially in developing countries.Keywords: Genetic, Male infertility, Clinical, Assisted Reproductive techniques, Seme

The genotoxic effect of lead and zinc on bambara groundnut (Vigna subterranean)

The effects of lead and zinc treatments on the chromosomes of bambara groundnut was investigated. The seeds of bambara groundnut were placed in Petri dishes in three replicates and allowed to germinate for five days in different concentrations: 25, 50 and 100 mg/L of both lead and zinc nitrates while the control group had distilled water. The total aberrations were examined. The mitotic index was calculated and the results were statistically evaluated by the analysis of variance at 5% significant level. The mitotic index decreased as the concentration increased (p<0.05). The highest mitotic index value was 3.40±0.88 for the control while the least was 1.30±0.48 for the 100 mg/L Pb treatment. The results show the most frequent chromosomal anomalies induced by these heavy metals as stickiness and bridges. Pb is much more genotoxic than Zn, as it induced more aberrations having percentage abnormalities of 92.3% while Zn had 30.0% for the highest concentration tested. Increased metal pollution can lead to some irreversible cytogenetic effects in plants and higher organisms. The study is an attempt to corroborate the toxic effect of lead and zinc on the chromosomes of plants. These results will be useful in environmental monitoring of the cytotoxicity of metals.Key words: Heavy metal, aberrations, genotoxic, cytogenetic, mitotic index

Removal of Pb and Zn from Soil using cowpea (Vigna unguiculata) and maize (Zea mays) Plants

This study investigated the potential of cowpea (Vigna unguiculata) and maize (Zea mays) plants to remove Pb and Zn from soil. The crops were exposed to three concentrations (100, 150 and 200 mgkg-1) of each metal salts during the study. When the plants were treated with lead nitrate at a concentration of 150 mgkg-1, the amount and percentage of Pb removed and accumulated within plants’ tissues were 65.68 m mgkg-1g/kg (44.79%) and 78.93 mgkg-1 (53.0%) for cowpea and maize with bioconcentration factors 0.80 and 0.78 respectively. However, when the plants were assisted they had greater bioconcentration factors. Farmyard manure enhanced metal uptake by cowpea and maize significantly than EDTA. Maize extracted more Pb into its roots and translocated to shoots when assisted with EDTA than cowpea. Maize was able to translocate more Pb while cowpea translocated more Zn through the vascular system, thereby acting as phytoextractors for the different metals respectively

The Influence of Pb and Zn Contaminated soil on the Germination and Growth of Bambara Nut (Vigna subterranea)

This research work takes a look at the possible phytotoxic effects of Pb and Zn as Pb(NO3)2 and Zn(NO3)2 on Bambara nut (Vigna subterranea) planted in polluted. Lead and zinc are common environmental contaminant found in soils. Unlike Zn, Pb has no biological role, and is potentially toxic to microorganisms. The bambara nut seedlings were irrigated with various concentrations of Pb and Zn (100,150 and 200mgkg-1) .Effect of these metals on the growth parameters (stem length/height, root length, leaf area, yellowness of leaves, fresh and dry weights) were measured. Influence of heavy metals on the microorganisms in the soil used for planting as well as the organic matter, pH and moisture content of the soil were also evaluated. The results showed that plant performance significantly reduced with increasing concentrations (100,150 and 200mgkg-1) of Pb and Zn contamination. The results show that a negative relationship existed between the different metal concentrations in the soil and the growth parameters (stem height, root length, leaf area, yellowness of leaves, fresh and dry weight) measured compared to control experiment. This study therefore reveals that these heavy metals have great implications on the sustainability of V. subterranea’s growth. These metals could pass down to humans through the food chain if animals eat such plants during grazing. This will affect their health, which may eventually lead to their death due to bio concentration and bioaccumulation. There would therefore be a need to explore ways of improving bambara nut production in areas of metal pollution. Keywords: V. subterranea, Bioaccumulation, Pollution, Phytotoxicity, Contamination, bioaccumulation

Maternal contribution to ultrasound fetal measurements at mid‑pregnancy

Background: Maternal variables are known contributors to fetal variables and can be assessed during pregnancy.Objective: To assess maternal contribution to some mid‑pregnancy fetal ultrasound measurements.Materials and Methods: A prospective study involving 87 pregnant women scanned at 18–23 weeks of pregnancy was carried out. The fetal measurements were head circumference (HC), abdominal circumference (AC), femur length (FL), and biparietal diameter (BPD) while the maternal variables were age, parity, height, weight, and BMI.Results: There were intercorrelations between some maternal and fetal variables respectively. Parity correlated significantly with all the ultrasound fetal measurements (P <.05), but the association vanished with partial correlation (P >.05). Significant correlation between parity and age remained the same with simple and partial correlations (P < 0.01). Canonical correlation analysis gave four sets of canonical variables; however, none was statistically significant. Regressing fetal parameters against parity through parent‑fetus regression procedure gave significant model fit (P < 0.05), but low r2 value suggesting that variations in parity did not explain much of the variations observed in the fetal ultrasound measurements (3.9% < r2 < 6.7%). The generated models revealed HC having the highest standardized regression coefficient (b = 5.07; P <.05) while FL had the least (b = 1.08; P <.05).Conclusion: The results suggested that parity contributed significantly to fetal ultrasound measurements at mid‑pregnancy while maternal height, weight, and BMI made no significant impact.Key words: Correlation; fetal; maternal; regression; ultrasound scan

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Evaluation of Association between Digital Dermatoglyphic Traits and Type-2 Diabetes in Lagos, Nigeria

Background: Diabetes is a very serious problem in the world today. In particular, the incidence of type-2 diabetes is rising in developing countries because of life style changes to that of westernized societies. Type-2 diabetes is usually a late onset disease. Thus, early identification of risk group individuals through a non-invasive method like dermatoglyphics will be very helpful.Objective: To see whether finger print pattern (dermatoglyphics) is associated with type-2 diabetes.Methods: Dermatoglyphic data were obtained from nondiabetic and type-2 diabetic subjects attending the Diabetic Clinic of Lagos University Teaching Hospital (LUTH) using a computer-assisted data capture system. The data were then analysed for association between the dermatoglyphic pattern and the subjects' health status with respect to type-2 diabetes.Results: Total finger ridge count (TFRC) was significantly higher (P&lt;0.05) in diabetic subjects than in non-diabetics. Results of cluster analysis suggested that dermatoglyphic pattern is associated with type-2 diabetes.Conclusion: In view of the association between finger print pattern and type-2 diabetes, dermatoglyphics may be used for early identification of risk group individuals for surveillance purposes with a view to preventing disease onset.Key words: dermatoglyphics; type-2 diabetes; finger prin

Parental determinants of offspring head circumference using a sample of patients attending a government hospital in Lagos, Nigeria

Background: Head circumference at birth is an important neonatal parameter in view of its association with perinatal and postnatal morbidity and mortality. It is an indicator of brain volume and a tool for assessing the development of the central nervous system. Being a complex  hereditary trait, predicting baby's head circumference from parental anthropometrics could complement the already existing ultrasonographic method of prediction.Objective: To identify the parental anthropometric determinants of baby's head circumference in Lagos, Nigeria, using a sample of patients attending a government hospital.Methods: Parental anthropometric parameters were obtained from 250 couples. The baby's head circumference was measured immediately after birth. The data were subjected to multivariate analysis.Results: The parental variables that were most predictive of babies' head circumference were mid-parental weight, maternal height, maternal weight gain during pregnancy and maternal age.Conclusion: Assessment of these parental attributes can complement ultrasonographic data in predicting baby's head circumference for better perinatal outcome.Key words: Head Circumference; anthropometricparameters; multivariate analysis; parental determinants