The association of male infertility with telomere length: A case control study

To study the relevance of sperm telomere length and infertility in men. : Our case-control study included twenty-five males in couple with sub-fertility/infertility (test group) and twenty five healthy males (control group) with proven paternity in the age group 25 to 35 years. The Absolute Sperm Telomere length (aSTL) was measured by real-time PCR. We investigated whether any significant difference in the aSTL value existed between the groups and analysed the relationship between aSTL and other sperm parameters.The mean (SE) aSTL recorded in the infertile cases was significantly shorter than for the control group being 140.60 (6.66) Kb/genome and 239.63 (12.32) Kb/genome respectively (p <0.001) A weak correlation was eminent between aSTL kb/genome and the total sperm count mil/ml (rho= 0.04, p - 0.86), progressive sperm motility (rho= - 0.02, p=0.934) and sperm viability (rho= - 0.07 p=0.741) in the infertile group. The measurement of aSTL by real-time PCR is a simple and rapid method that offers further paramount information with respective to the quality of sperm. It is befitted for epidemiological studies, hence opening new perspectives in the evaluation of male infertility. Limitations - Our study was confined to men aged between 25 and 35 years. Further comparative studies are needed to explore the significance of STL and infertility in older males. Additional studies will help illumine the significance of aSTL as a prognostic biomarker in assisted reproduction.

Teaching cadaveric laparoscopic anatomy in medical curriculum – An essential learning option

Teaching anatomy to the medical students is shifting from learning the traditional gross anatomy with didactic lectures to learning anatomy by laparoscopic dissection on the cadavers. The open dissection hall teaching is loosing relevance to learning clinical anatomy with laparoscopic dissection live by the medical students. Laparoscopic demonstrations can generate interest in surgery in the students that would otherwise not be possible in the preclinical years. Additional advantages of laparoscopic anatomy learning are improved three-dimensional orientation, increased dexterity and development of team working skills among students. The magnified laparoscopic views and the ability to deeply explore anatomical features to demonstrate the basic anatomy better with full clarity does makes an impression on the young medical students. The major disadvantage is student may feel the lack of pleasure of tactile sensation, of touching the anatomical organs during laparoscopic demonstration.

A study on association of serum uric acid and blood pressure in hypertensives at a tertiary care centre

Hypertension(HTN) is the most common and significant cardiovascular disease because of its prevalence and severity of the damage to the mankind globally. Hyperuricemia, a condition of increased levels of Serum Uric acid (UA) has been proposed to have an association with hypertension in various studies. In certain studies, serum uric acid levels has been found to be an independent predictor for developing hypertension. On the basis of the above observations, we have proposed to the present study to compare the relationship between serum UA and hypertension in a single cohort with adjustment of all possible confounding factors.A total of 245 subjects were enrolled in this study during a regular routine health checkup. All subjects were informed about the study aims Individuals having a known history of gout and cardiac or severe renal diseases and patients who are already under medication for anti-hyperuricemic were excluded from the study. General information like Name, Age, Sex, Occupation, Address along with history of any drug intake and anthropometric indices - body weight (BW), body height (BH), hip circumference (HC), waist circumference (WC), and lifestyle information have been obtained. The data has been arranged in tables with mean ± SD for further analysis. The data is analyzed using IBM SPSS version 23. The difference between the groups for baseline variables was done by independent sample t-test (two-tailed). Pearson’s correlation coefficient test was performed to assess the interrelationships between baseline variables and SUA concentrations. The differences for the variables among the groups was determined by using One-way ANOVA.Of the 245 subjects, mean age of the participants was 42.4 ± 8.4 years (range 18–70 years). There was no significant difference in the mean levels of Height, Weight and BMI between the two groups. Mean levels of WC, HC were significantly different between two group (p < 0.05) subjects. The mean levels of SBP and DBP were also significantly more in the hypertensive subjects (p < 0.001). In Pearson’s correlation coefficient test, SUA levels were significantly related with SBP and DBP. In this study, we have observed comparatively a stronger relationship for SUA concentration with hypertension and prehypertension in the participants. The extended mechanism for the effect of SUA on hypertension is yet to be elucidated. There are some hypotheses partly explain the association between SUA and high blood pressure. One of the possible mechanism might be uric acid deposition on the blood vessels walls activates the renin-angiotensin system, suppress the liberate of carbon monoxide, enhance inflammation, and leads to vasoconstriction on later stage, which consequently leads to hyperplasia and incidence of hypertension. Another possibility involving oxidative stress and endothelial dysfunction associated with high SUA levels may contribute to high blood pressure.

A cadaveric study of relationship of external carotid artery with reference to adjacent anatomical landmarks

Evaluation of carotid bifurcation level and relationship of External Carotid Artery (ECA) with reference to adjacent anatomical landmarks is important in planning various surgical and radiological procedures related to the carotid arteries. The aim was to study the relationship of External Carotid Artery with reference to Adjacent Anatomical landmarks in cadavers. 60 cadavers - 52 male and 8 female embalmed with 10% formalin were dissected over the period of two years for this study. The distance between the origin and the termination of ECA was found to be in the range of 25–70 mm on the right side and in the range of 25–68 mm on the left side. The distance between the origin of ECA and the carotid tubercle was found to be in the range of 23–50 mm on the right side and in the range of 22–48 mm on the left side. The distance between the origin of ECA and the angle of the mandible was found to be in the range of 18–30 mm on the right side and in the range of 20–32 mm on the left side. The anatomical knowledge of relationship of External Carotid Artery with reference to adjacent anatomical landmarks is helpful for vascular surgeons to plan surgeries and prevent complications during various diagnostic and therapeutic procedures.

Incidence of hearing impairment in at risk babies

Babies treated in neonatal intensive care are prone for hearing problems and with the decrease in infant mortality, babies who survive many perinatal risk factors are increasing. Deafness in 1st three years of life may impair the full development & maturation of auditory system & it is well known that deafness in infancy & childhood interferes with normal development of speech & language. To prevent this & to initiate rehabilitative procedure as early in life as possible a screening method to detect auditory disabilities in newborns is of great importance. Based on this background the present study determine to evaluate to know the incidence of hearing impairment in infants at risk.This is a prospective observational study conducted in JJM Medical College, Davanagere, Karnataka. A total 940 patients attended to JJM Medical College and Hospital and diagnosed with hearing impairment according to American Joint Committee statement on infant hearing screening (JCIH) criteria. All the patients under 2 years with history of high risk factors – pre–term, low birth weight, birth asphyxia, neonatal seizures, and hyperbilirubinemia were selected for the study. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem evoked response audiometry (BERA) if the second OAE was negative. Out of 940 high risk cases, 350 had profound hearing loss, 83 had severe hearing loss, 125 had moderate hearing impairment, 36 had mild hearing impairment &346 had normal hearing sensitivity. Out of 48 patients with normal hearing sensitivity, 53 patients were preterm, 166 had hyperbilirubinemia, 23 had neonatal convulsions, 68 birth asphyxia, 89 were of low birth weight. Out of 147 cases 31 patients had mild/moderate hearing impairment.Neonatal jaundice carries the highest risk of hearing impairment followed by birth asphyxia, neonatal convulsions and low birth weight.BERA is the tool which can confirm the normal sensitivity of hearing whenever required & is very useful in early detection of hearing loss and planning rehabilitative procedures.

Evaluation of biparietal diameter and femur length by ultrasonography method, its correlation with fetal gestational age a comparative study in Chhattisgarh state of India

There few studies which tried to corelate biparietal diameter and gestational age in which an increase in biparietal diameter with the increase in gestational age was found but there was a discrepancy between 17 week of pregnancy and term and which is approximately 3 weeks. We conducted the present study to compare the gestational age and femur length and biparietal diameter in the population of Chhattisgarh state of India.A total of 380 pregnant females were enrolled for the study. They were between the 20 weeks to 38 weeks of gestation with their age ranging from 18-35 years.In the present study we observed a total of 158 cases in 2 trimester i.e. ranging from 20 to 27 weeks and 220 cases were in 3 trimester of pregnancy. Mean of BPD and FL observed was 73.1 and 56.2 respectively. The standard deviation and standard error of mean for biparietal diameter and femur length were 12.8, 11.6 and 0.63, 0.57 respectively.All parameters of present study are found to be highly correlated with gestational age. (r=, 0.987, 0.980 for, FL and BPD respectively).

Study of contributing arteries to superficial palmar arch formation

The superficial palmar arch (SPA) is formed predominantly by the ulnar artery with a contribution from the superficial palmar branch of the radial artery.: To study contributing arteries in superficial palmar arch formation and variations in its formation.: Study comprised of 30 upper limbs from 15 cadavers. Palmar arches in them were dissected following classical incisions and dissection procedures of Cunninghams’ manual.: SPA was formed by superficial branch of ulnar artery only in 13.33% specimens, by superficial branch of both ulnar and radial artery in 70% specimens, by superficial branch of ulnar and persistent median artery in 13.33% specimens and was formed by superficial branches of ulnar and radial arteries with persistent median artery in 3.33% specimens. SPA was complete in 80% and was incomplete in 20% specimens.: The arch formation is highly variable. Knowledge of contribution to the SPA will be helpful to the reconstructive hand surgical procedures such as arterial repairs, vascular graft applications and re-implantations.

Implementation of use of hand-made three-dimensional models to teach Anatomy with supplement to traditional methods with limited resources

The status of anatomical education in modern medical programs is a cornerstone of medicine. Anatomy is one of the basic subjects in First Year MBBS curriculum. Apart from important it is also a lengthy subject to complete in allocated time duration of First MBBS. There are various subdivisions of anatomy like gross anatomy, developmental anatomy, microscopic anatomy, genetics, surface anatomy, radiological anatomy etc. Out of which gross anatomy is difficult to understand as time constraint is there in duration of First MBBS. In medical and allied branches total hours allocated for anatomy teaching and laboratory practical hours have reduced. Result in triggered the emergence of innovative ideas to maximize students learning. While studying the gross anatomy three-dimensional orientation is must to learn actual structure and relation with other viscera and vessels. Traditional way of teaching anatomy uses wall charts, books, slides, anatomical specimens, and practical anatomy as teaching resources and methods. It is fact that in most institutes, three dimensional models are available in their Anatomy Museum, but many Anatomists have complained about fault in exact structure, labelling and it’s relationship in these models because sometime these models are made by amateur technicians. As the medical education expanded and the reduction in human anatomical specimens due to shortage of dead body donations, as well as the limitations of time, place and other resources for anatomical training, the quality of anatomy teaching has been seriously affected. Apart from shortage of these resources, another big issue with development of skill laboratory which is now mandatory as per new NMC guidelines. Establishment of skill lab requires ample amount of finance. Though, skill lab can provide excellent resources to meet the existing lacunae in teaching Anatomy to students by virtual media and simulations. Latest innovations in better teaching aids in Anatomy, in market virtual dissection table is available now, which can provide in depth understanding and orientation of three-dimensional body structures. But as mentioned above, the cost of this virtual dissection table is too high that every institute can not able to afford it. In this situation, to provide better understanding and three-dimensional orientation to students making hand made models from cheap and easily available materials are better options for teachers and students as they can make themselves.Anatomy is a discipline where spatial visualization is of importance. Even anatomy textbooks and atlases provide two-dimensional static anatomical illustrations. To teach some anatomical structures by traditional cadaveric dissection or by traditional lectures is difficult. Some of the structures like gross anatomy of urinary bladder or facial nerve anatomy are difficult to learn by textbook which cannot give exact perception of real anatomy. Additionally, many structure get distorted while removing from cadaver or not able to trace even. In some cases, specific models are also not available for instance course of facial nerve from origin to its termination where hand-made models give excellent three-dimensional understanding. For students’ proper anatomical knowledge of anatomy/organs help them to improve surgical skills. Finally, surgical outcome will be better with less morbidity and mortality.

An insight of association of insulin resistance with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), a multifaceted condition, often has salient features like insulin resistance (IR). Abnormal alternation in insulin synthesis and function usually alters PCOS expressivity by deviating molecular and biochemical activity underlying this pathophysiology.This review intends to unveil the molecular basis of the genetic polymorphism of IR and its correlation with PCOS. It also highlights the existing methods of IR estimation. Searching of different articles using keywords including PCOS, IR, and polymorphism in various databases was performed to illustrate the review article.POCS, and IR are complex and multifactorial conditions in terms of the contributing factors, their interactions, and expressivity. Further studies on diversified genotype responses to environmental and ethnic variances are required for precise understanding.Insulin resistance (IR) and polycystic ovary syndrome (PCOS) are intricately interacted conditions that abnormally alter functions from genetic to organ system level. Complex gene-environment interactions make it difficult to understand the etiology and manifestation, and so diagnosis and management approaches of the heterogeneous pathophysiology are not foolproof. Further studies on genetic susceptibility related to ethnic distribution are essential for the implementation of personalized treatment of IR and PCOS.

Topography of the location of mental foramen in dried edentulous human mandible and its clinical implication

The mental foramen is an oval or round opening on external surface of mandible and transmits mental nerve and vessels. Mostly located at apex of second mandibular premolar or between the apices of premolars. The study was commenced on 60 dried edentulous mandibles with the aim to determine location of mental foramen(MF) with reference to surrounding anatomical landmarks. By measuring its distance from midline (symphysis menti), posterior border of ramus of mandible, lower border of mandible. Length of lower border (Base) of mandible was also measured. In present study most common shape of mental foramen was round (70%). The mean distances of MF from midline are 24.36mm on right side and 24.15mm left side. From posterior border of ramus are 64.45mm on right side and 64.15mm on left side. From base of mandible are 12.29mm on right side and 12.48mm on left side. Length of base mandible (midline to angle of mandible) is 83.27mm right side and 83.12mm left side. Ratio of distance from symphysis menti to MF and length of base of mandible are same on both sides that are 0.29. There is statistically significant positive correlation between distance from symphysis menti to MF and length of base of mandible.The MF plays a very important role in treatment planning and its location needs to be considered prior to placement of dental-implants, regional anesthesia, osteotomy-surgeries and during complete denture-fabrication in order to avoid MN injury and related complications.