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

A Parallel Tabu Search Algorithm for Optimizing Multiobjective VLSI Placement

Abstract. In this paper, we present a parallel tabu search (TS) algorithm for efficient optimization of a constrained multiobjective VLSI standard cell placement problem. The primary purpose is to accelerate TS algorithm to reach near optimal placement solutions for large circuits. The proposed technique employs a candidate list partitioning strategy based on distribution of mutually disjoint set of moves among the slave processes. The implementation is carried out on a dedicated cluster of workstations. Experimental results using ISCAS-85/89 benchmark circuits illustrating quality and speedup trends are presented. A comparison of the obtained results is made with the results of a parallel genetic algorithm (GA) implementation

Development of a single combined microencapsulated formulation of allopurinol and nimesulide and investigation of their release behaviours

The aim of this study was to develop a single combined once-daily sustained release microencapsulated dosage form of Allopurinol and Nimesulide using Ethyl cellulose as release controlling factor and to evaluate drug release parameters as per various release kinetic models. In order to achieve required sustained release profile, microparticles were prepared using coacervation thermal change technique. The formulated microparticles were also characterized by physical and chemical parameters and results were found in acceptable limits. Different dissolution models were applied to drug release data in order to evaluate release mechanisms and kinetics. The drug release data fit well to the Higuchi expression. Drug release mechanism was found as a complex anomalous one

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

The PAK-U.S. alliance in the fight against terrorism: a cost-benefit analysis

The cost-benefit equation of the Pak-U.S. alliance, in the fight against terrorism, reflects a direct correlation between the fluctuating patterns of U.S. assistance and their direct and indirect implications for Pakistan. While the U.S. strives to achieve a better return on its investment through military-oriented support, Pakistan seeks to adopt an approach that suits both the U.S. and its own domestic and regional interests. This research traces the trend of Pak-U.S. relations, highlights the impact of the fluctuating U.S. aid in shaping perceptions, and provides a game theoretical analysis on the issue. Besides highlighting measures to achieve cost effectiveness through micro alliances, decentralization, accountability, and transparency in fund management, the study supports development of entrepreneurial culture and micro-alliances in Pakistan. More importantly, it provides an in-depth analysis of the military and population-centric approaches and their associated costs and benefits for the two countries. The research concludes by suggesting a more population-centric U.S. approach towards Pakistan to achieve a better return on investment besides laying foundation for a long-term strategic alliance. It suggests future research on the prospects and methodology of achieving a long-term partnership between the two nations.http://archive.org/details/thepakuslliancei1094510631Pakistan Air Force autho