Semen parameters in male partners of sub-fertile couples.

Objective: To evaluate the frequency of semen parameters in male partners of in sub-fertile couples. Study Design: Cross-sectional study. Setting: Department of Gynaecology, Bakhtawar Ameen Hospital, Multan. Period: July 2019 to July 2020. Material & Methods: Infertile couples from at least 12 months were selected for study. A team of Gynaecologist, andrologist and endocrinologist assessed the couples. In male partner, general physical examination, endocrine factor, genetic assessment, accessory gland infection and testicular dysfunction were evaluated. Semen sample was sent to laboratory for semen analysis. Results: In a total of 169 sub-fertile couples, the mean age of male and female partner were 37.98±4.54 years and 32.51±3.78 years respectively. Mean duration since marriage was 5.17±4.51 years. Abnormal semen parameters such as azoospermia, oilgo-azoospermia, asthenozoospermia, teratozoospermia and aspermia were noted 21 (12.4%), 26 (15.4%), 48 (28.4%), 18 (10.7%) and 10 (5.9%) subjects respectively. There were 46 (27.2%) subjects with normal semen parameters. Conclusion: Most of the male sub-fertile subjects had asthenozoospermia. More than one fourth of the subjects had normal semen parameters.

Assessment of Age at the Stages of the Eruption of Third Molar Teeth among the People of North-Eastern India

Background and Objectives. In the biological age determination of a person’s teeth at adolescence, the third molar (M3) or wisdom tooth development is considered a dependable method used over the years. The present research intended to evaluate the age from the eruption status of M3 and analyze and equivalence with a different quadrant of the jaws. Methods. A cross-sectional descriptive and analytical study was undertaken with 1060 Assamese individuals (642 males and 418 females) aged 14–26 years and was subjected to a clinical, dental, and general physical examination from January 2014 to December 2018. The data were statistically analyzed using Microsoft Excel and the Statistical Package for the Social Sciences (SPSS) version 22. The significant differences among variables were tested using the chi-square test and Student’s t -test, considering a p value < 0.05 as significant. Results. The carried-out research showed no eruption (NE) status of M3 with an overall mean (±SD) age at 17.39 (±2.273) years, although a significantly lower age among males with a mean age of 16.92 (±2.138) years ( p value < 0.001) was observed. The mean age (overall) for the complete eruption (CE) was observed at 20.33 (±2.566) years, which was seen earlier in males. The mandibular M3 appears earlier compared to the maxillary M3. The third molar eruption (TME) on both left and right quadrants of the jaw was observed substantially earlier in the lower jaw, compared to the upper jaw ( p value < 0.025). The earliest CE of M3 was marked at 15 years. The differences in the frequencies of TME in different chronological age groups were found significant ( p value < 0.001). A significant association between gender and TME ( p value < 0.045) in the current study is worth noting. Conclusion. Thus, determined by TME as a valid method, age can be used for various purposes to establish a person’s identity. Dental age estimated using third molar eruption status has a weighty association with chronological age. Thus, it should be utilized to determine the likely age of an individual.

A study on otorhinolaryngological manifestations in pregnant women

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3^rd trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2^nd and 3^rd trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>

A prospective observational to study sociodemographic profile, clinical profile and pattern of gynecological malignancies in a tertiary care center in Himachal Pradesh

Background: Cancer is the second leading cause of death globally and is estimated to account for 9.6 million deaths in 2018. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. The aim of the study was to study the sociodemographic profile, clinical profile, pattern of gynaecology malignancies and their histopathological findings of all gynaecological malignancy patients attending gynaecological OPD.Methods: A prospective observational study was conducted in the Department of OBG, KNH Shimla from June 2019 to May 2020 where 241 gynaecological malignancy patients were recruited. Detailed history, general physical examination, systemic, gynaecological examination and required investigation was done and the data was analysed.Results: The most commonly occurring gynaecological malignancy was cervical cancer. 82.2% of the patients belonged to the age group 40-69 years. Majority of the patients were multiparous, belonged to rural background, belonged to Hindu community. 69.3% were menopausal. Among the 132 women who gave history of age at first coitus as less than 18 years, 60.6% of them had cervical cancer. Most common presenting complaints was post-menopausal bleeding. In cervical cancer 43.6% of patients diagnosed at stage III and were managed by radiation therapy.Conclusions: According to this study, cervical cancer is the most common gynaecological malignancy followed by ovarian cancer. Most of these patients seeked medical attention in advanced stage.

Isolated café-au-lait macules: Think of neurofibromatosis type V

Sir, Segmental neurofibromatosis (SNF) is a rare form of neurofibromatosis (NF) with a reported prevalence of 0.0014%–0.002%. It is included in Riccardi’s classification as type V NF [1]. It is characterized by café-au-lait macules and/or neurofibromas distributed in only one dermatome, less commonly in two or more dermatomes [2]. Roth et al. reclassified SNF into four subtypes: true SNF, localized SNF with deep involvement, hereditary SNF, and bilateral SNF. A limited number of cases of SNF have been reported with systemic involvement, such as visceral neurofibromas, skeletal abnormalities, and renal agenesis [1]. Laser therapy may be performed if an aesthetic demand arises. Herein, we report a case of SNF in a young boy with no systemic disease. An eleven-year-old male was sent by his pediatrician for skin spots that appeared at the age of four. The young patient came from a non-consanguineous marriage and had no family history of skin disease. A general physical examination revealed normal parameters, such as weight, size, intelligence, speech, auditory function, and visual acuity. A dermatological examination found unilateral café-au-lait macules with a ranging size of 1 to 5 mm in the right half of the trunk with no crossing of the midline (Figs. 1a and 1b). We thoroughly examined the boy and found no other features of neurofibromatosis, including neurofibromas, neurological deficits, or bone abnormalities. We assured the patient and his parents that this was a benign disease, so the risk of developing any disease-related complications was low. Annual monitoring was started. No therapy was proposed because the patient expressed no aesthetic demands.

To Determine the Frequency of Common Site of Lodgment of Foreign Body in Respiratory Tract of Children

Aim: To determine the frequency of common site of lodgment of foreign body in respiratory tract of children. Setting: Pediatric and ENT Departments, Khyber Teaching Hospital, Peshawar. Study Design: Descriptive cross-sectional study. Duration of Study: six months i.e. 30/6/2018 to 30/12/2018 Methodology: 300 cases were included. Demographic characteristics like, name, age, gender and address was recorded. H/O inhaling a specific foreign body and time elapsed was noted. General physical examination for signs of respiratory distress was noted. Chest X ray was performed. Examination of oral cavity and nostrils was performed for a suspected foreign body. If nothing found, the patient was immediately shifted to ENT department for emergency bronchoscopy to remove the suspected foreign body. The type of foreign body recovered and the site of respiratory tree from where it is removed were noted. Results: Mean age was 12 years with SD ± 2.16. 51% children were male while 49% children were female. Site of lodgment of foreign body among 300 patients was analyzed i.e. 1% patients had oral cavity, 7% had nasal cavity, 1% patients had oro-pharynx, 3% patients had larynx, 13% patients had main trachea, 30% had right bronchus, 15% patients had left bronchus, 1% patients had right bronchiole, 1% patients had left bronchiole in respiratory tract of children. Conclusion: Frequency of site of lodgment of foreign body was i.e. oral cavity 1%, nasal cavity 7%, oro-pharynx 1%, larynx 3%, main trachea 13%, right bronchus 30%, left bronchus 15%, right bronchiole 1% and left bronchiole 1%. Keywords: Lodgment, foreign body, respiratory tract, children.

COAGULATION PROFILE IN DIFFERENT TRIMESTERS OF PREGNANCY TO IDENTIFY HIGH RISK PREGNANCY

Background: The physiological changes in pregnancy may serve to protect the mother from the hazard of bleeding imposed by placentation and delivery, but they also carry the risk of an exaggerated response, localized or generalized, to coagulant stimuli. After correlating the trends of coagulation profile in all three trimesters of pregnancy with parameters [Body Mass Index (BMI), Glycemic status, Blood Pressure Status]; We can find out high risk pregnancies so that special attention can be given during pregnancy, labour and postpartum period. Material & Methods: A observational prospective analytic study done on 100 Pregnant ladies who were visited to routine antenatal clinic in the department of Obstetrics & Gynecological SMS Medical College and attached group of hospitals, on outdoor basis were selected in their first trimester (after 8 week gestation) in SMS medical college & attached group of hospitals during April 2017 to March 2018. The study protocol was approved by the Institutional Ethics Committee. All participants submitted informed consent before enrolment. After taking proper history, all the subjects underwent clinical examination comprising of general physical examination, assessment of vital parameters and systemic examination. Results: Our study that the mean age of study subjects was 26.46 ± 3.34 years. There was significant but weak positive correlation of D Dimer with BMI and Blood sugar in all trimesters of pregnancy. Significant correlation was found between APLA with DBP and MAP in 1st trimester of pregnancy. No correlation was found between APLA and other parameters in any trimester of pregnancy. Conclusion: We concluded that there were increased in FDP, D-Dimer, INR, APLA while platelets count, PT and aPTT were decreased. Further prospective study will be required to measure the outcome of pregnancy so we can define a high-risk pregnancy and those will get special attention in peripartum period. Keywords: Trimester, Pregnancy, D Dimer, BMI, Blood pressure, Correlation

Emerging role of C-peptide as an early biomarker of metabolic syndrome

Background: Metabolic syndrome is a health issue of rising concern as it has a correlation with the occurrence of cardiovascular events. Early identification of this syndrome by evaluating levels of biomarkers such as C peptide can help medical professionals prevent the occurrence of life-threatening cardiovascular diseases.Methods: This cross-sectional study was carried out in 89 subjects who were diagnosed to have metabolic syndrome. General Physical examination was done and fasting C peptide and insulin levels were quantified, followed by statistical analysis and their correlation. The prevalence of defining parameters of Metabolic Syndrome as per IDF 2005 was studied.Results: Out of 89 (100%) subjects, 80 (89.8%) subjects (Mean±SD=6.14±3.47) had C- peptide level >1.89 ng/ml which was statistically highly significant (p<0.001). Also, out of 89 (100%) subjects, 67 (24.71%) subjects had insulin level <25 mIU/L which was statistically significant (p<0.001).Conclusions: It was thereby concluded that serum C peptide levels were raised in patients of Metabolic syndrome and it is superior to serum Insulin levels as an early biomarker of the same.

Fetomaternal outcome in pregnancies complicated by fibroid

Background: Fibromyoma (leiomyoma) is the most common benign tumour of the uterus. Approximately 10% to 30% of women with uterine fibroids developed complications during pregnancy. The aim of the study was planned to ascertain the fetomaternal outcome in pregnancies complicated by fibroid.Methods: A hospital based cross-sectional study was conducted among pregnant women with documented uterine fibroid who was admitted for any complication or delivered in the department of obstetrics and gynaecology, RIMS, Imphal from September 2017 to August, 2019 in the department of obstetrics and gynaecology in collaboration with department of paediatrics, Regional institute of Medical Sciences, Imphal. Detailed clinical history and socio-demographic profile were recorded in pre-designed proforma. General physical examination and systemic examination and obstetrical examination was carried out for the participants.Results: Major proportions was in the age group of 30-39 years (73.9%). Fibroids were more frequent in primigravida (76.1%) followed by P1 (15.2%) and ≥P2 (8.7%). Out of 46 patients 43 (93.5%) delivered by CS (69.76%), NVD (25.58%) and instrumental delivery (4.65%) while 3 patients (6.5%) undergo spontaneous abortions. Most common myoma found in this study was intramural (47.8%) followed by submucous (34.8%) and subserosal (17.4%). Out of 43 deliveries most common complications found was atonic PPH (6.97%) and placenta previa (6.97%) followed by degenerations (2.32%), abruptio placentae (2.32%), malpresentations (2.32%). Out of 43 deliveries 6.9% baby born with low birth weight, IUGR (6.9%), IUFD (4.6%), NICU admission (4.65%) and early neonatal death (2.32%).Conclusions: Pregnancies with fibroids are considered as high-risk pregnancy associated with complications during the antepartum, intrapartum, postpartum period. Pregnant women with myoma can be advised for regular ANC along with TAS for early diagnosis and management of complication.

Libido and serving skills of Zebu cattle bulls

The goal of this study was to evaluate the rejection rates of Zebu bulls during behavioral assessment (libido and serving ability) and the importance of this step in bull breeding soundness evaluation (BBSE). A total of 1,534 bulls reared in the state of Rio Grande do Sul, Brazil, of Nelore (1,340), Brahman (76), Guzerá (98), and Tabapuã (210) breeds were evaluated. The evaluation consisted of four steps. Step I was the general physical examination, Step II genital tract examination, Step III semen evaluation, and Step IV behavioral assessment of libido and the ability to complete copulation. To evaluate the relationship between the binary variables of approved or rejected during different steps of the BBSE, and age groups (young and mature bulls), chi-square tests and logistic regression were used. The general rejection rates in the BBSE were 5.64% and 15.20% for young and mature Zebu bulls, respectively. Problems with the sexual behavior (libido and/or serving ability) of bulls accounted for the rejection of 0.46% and 2.29% of young and mature Zebu bulls, respectively. The lack of libido and serving ability was shown to be an important problem concerning the total number of possible causes of Zebu bull rejection during the BBSE. This result suggests that the behavioral step should be performed regularly, rather than being complementary to the standard BBSE in Zebu cattle.