Evaluation of the complete profile of male partners in infertile couples with special emphasis on detection of genital tuberculosis

Background: To evaluate the complete profile of male partners in infertile couples with special emphasis on detection of genital TB. Methods: The study was conducted in the fertility clinic of department of obstetrics and gynaecology, Maulana Azad Medical College and Associated Lok Nayak and GB Pant Hospitals, New Delhi from August 2015 to December 2016 among 100 infertile couples. Detailed history, general physical and local examination of male partners was done. Routine blood and urine tests, combined with radiology examination of chest and mantoux skin test of male partners were done followed by investigations specific to male factor evaluation. Two semen samples collected after 3-5 days of sexual abstinence were analyzed to assess semen parameters such as volume, total sperm count, total motility and morphology. Ultrasound and colour Doppler of scrotum and hormone analysis was done in all cases of azoopermia, oligoasthenospermia or asthenospermia. Testicular FNAC was done for all cases of azoospermia and oligoasthenospermia to establish cause of male infertility. Results: 72% couples had primary infertility. 34% males were daily tobacco chewers. 8 males had varicocele and 2 had undescended testes on examination. 60% males had semen analysis in the normal range and 19% had azoospermia. Tobacco chewing, testicular size abnormalities, varicocele, hydrocele were significantly associated with abnormal semen findings. A statistically significant relation was found between elevated S.FSH and semen analysis findings. A statistically significant association was found between penile meatal stenosis, chest X-ray, mantoux test with history of TB in male/female partner. Conclusions: Primary infertility was more common than secondary infertility in our study group. Addiction was found to be an important factor in infertile men particularly tobacco chewing. Elevated Serum FSH levels were a common finding in males with azoospermia and oligoasthenospermia

Shaping public behavior and green consciousness in India through the ‘Yo!Green’ Carbon Footprint Calculator

Climate change poses one of the greatest challenges of any kind facing human society today. It is a threat to the availability of land, air, food and water – all of which are key constituents of the Sustainable Development Goals. Much of the observed change in climate is anthropogenic in nature. Hence, it is imperative for all human societies to make a positive contribution in spreading greater public awareness and engagement for creating a more sustainable world. Due to the lack of a reliable carbon footprint measurement system specific to Indian conditions, a robust multimedia application has been developed and designed in the form of India's first certified Carbon Footprint Calculator. Titled the ‘Yo!Green’ Carbon Calculator, it allows individuals and households to measure their greenhouse gas emissions, and recommends simple mitigation measures based on their emission profile. This paper presents the methodologies, assumptions and processes which have been adopted to develop the Yo!Green Carbon Calculator

Does Intrauterine Instillation of Human Chorionic Gonadotropin Hormone (hCG) Before Embryo Transfer (ET) Improve Pregnancy Outcomes in in-vitro Fertilization (IVF) Cycles?

Objective: To study the effect of intrauterine instillation of human chorionic gonadotropin hormone (hCG) before embryo transfer (ET) on pregnancy outcomes in women undergoing in-vitro fertilization (IVF) cycles. Materials and Methods: The study was an age and anti-mullerian hormone (AMH) level-matched case–control study. Total 80 women of age group 25 to 40 years were recruited who were undergoing IVF for mild male factor, tubal factor, or ovulatory dysfunction. Two groups were formed and age matched. Study group (n = 40) received 800 IU of hCG 5 min before ET, whereas control group (n = 40) underwent direct ET without prior instillation of hCG. The pregnancy outcomes were compared between the two groups. Result: Primary outcome was implantation rate (IR). IR was significantly higher in study (hCG) group as compared to control group (30.95% vs. 15.29%, P = 0.016). Secondary outcomes were clinical pregnancy rate and live birth rate. Study group had higher pregnancy rate as compared to control group, but the difference was not statistically significant (40% vs. 25%, P = 1.0). Live birth rate was higher in study group but not significant (35.5% vs. 22.5%, P = 0.35). Abortions were comparable in both the groups. Conclusion: Intrauterine hCG before ET significantly improves IR and resulted in better IVF outcomes

Management of anterior segment penetrating injuries with traumatic cataract by pentagon approach in paediatric age group: Constraints and outcome

Purpose: To evaluate the efficacy of multiple combined procedure (Pentagon approach) as single-step secondary repair in cases of extensive keratolenticular trauma in paediatric age group. Methods: Retrospective evaluation of 18 patients of penetrating injuries with sclero-keratolenticular trauma, who underwent multiple procedure as single-step secondary repair by a single team of two surgeons during a 4 year period. Surgical procedure included reconstruction of anterior segment, synechiolysis, excision of membrane, lensectomy, open sky vitrectomy, PC IOL implantation over frill and penetrating keratoplasty. Meticulous antiamblyopia measures were applied in all cases. Results: Extensive vasoproliferative membrane, complicated cataract and anterior vitreous condensation were significant intra-operative hurdles. Moderate uveitis, secondary glaucoma, persistent epithelial defects were problems noted. Eleven (61.22%) patients attained good visual outcome. Regrafting was required in remaining cases due to delayed graft failure. Conclusion: Despite being a highly complex technique, Pentagon approach provides effective management profile in terms of graft success and functional outcome, especially in keratolenticular trauma, in children

Role of Human Epididymis Protein 4 in Tumour Angiogenesis

HE4 is a secretory protein. It is expressed in reproductive tract and respiratory epithelium in normal individuals. Serum level of HE4 is raised in various solid cancers that give us an advantage to use it as a diagnostic and prognostic biomarker. It is an established biomarker of epithelial ovarian cancer [EOC]. It has also shown the significance in various other malignancies like cancer of endometrium, cervix, lung and breast. Studies show HE4 as an independent prognostic biomarker in non-small cell lung carcinoma. Its raised values in cancer signify its role in oncogenesis. HE4 promotes angiogenesis via STAT3 signalling pathway. In this paper we have tried to illustrate about human epididymis protein 4 and its role in tumour angiogenesis

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

Background. The association between economic status and kidney disease is incompletely explored even in countries with higher economy (HE); the situation is complex in lower economies (LE) of South Asia and Southeast Asia (SA and SEA). Methods. Fifteen countries of SA and SEA categorized as HE and LE, represented by the representatives of the national nephrology societies, participated in this questionnaire and interview-based assessment of the impact of economic status on renal care. Results. Average incidence and prevalence of end-stage kidney disease (ESKD) per million population (pmp) are 1.8 times and 3.3 times higher in HE. Hemodialysis is the main renal replacement therapy (RRT) (HE-68%, LE-63%). Funding of dialysis in HE is mainly by state (65%) or insurance bodies (30%); out of pocket expenses (OOPE) are high in LE (41%). Highest cost for hemodialysis is in Brunei and Singapore, and lowest in Myanmar and Nepal. Median number of dialysis machines/1000 ESKD population is 110 in HE and 53 in LE. Average number of machines/dialysis units in HE is 2.7 times higher than LE. The HE countries have 9 times more dialysis centers pmp (median HE-17, LE-02) and 16 times more nephrologist density (median HE-14.8 ppm, LE-0.94 ppm). Dialysis sessions >2/week is frequently followed in HE (84%) and 10% in all the HE countries except Taiwan, 10%–20% in the majority of LE countries. Conclusion. Economic disparity in SA and SEA is reflected by poor dialysis infrastructure and penetration, inadequate manpower, higher OOPE, higher dialysis dropout rates, and lesser renal transplantations in LE countries. Utility of RRT can be improved by state funding and better insurance coverage