Spontaneous pregnancy outcome after surgical repair of clinically palpable varicocele in young men with abnormal semen analysis

Objective: The beneficial effect of varicocele repair in male infertility remains unresolved. The aim of this study was to identify the benefit from varicocele treatment based on pregnancy rate rather than improvement of semen quality.Subjects and Methods: This study included 141 infertile men with varicocele detected by clinical examination and confirmed by venous reflux on continuous wave Doppler ultrasonography (US). Measurement of Body Mass Index (BMI) and hormonal assays were performed in all patients. A total of 233 sub-inguinal varicocele repairs were done. Couples were followed up with semen analysis and pregnancy detection for 6, 12 and 18 months. Statistical analysis was performed using the chi-square, t-test and Mann-Whitney test where appropriate (p <0.05 accepted as statistically significant).Results: The spontaneous pregnancy rate was significantly greater in men with low or normal BMI. There were statistically significant differences between postoperative mean sperm count (64.7±6.8 and 10.5±1.8 million/ml) and progressive motility (38.3±2.4 and 17.7±1.8%) for spontaneous pregnancy and non-pregnancy, respectively. There were also significant changes from pre- to postoperative mean sperm concentration (21.5±2.1 and 64.7±3.8 million/ml), progressive motility (12.9±1.8 and 31.7±1.4%) and normal morphology (54±1.3 and 81.3±4.6%) in the spontaneous pregnancy cohort. Comparing pre- and postoperative serum hormone levels, FSH and prolactin decreased significantly in spontaneous pregnancy (6.57±0.65 to 4.6±0.53 IU/L and 166.2±11.8 to 149.3±10.4 pmol/L, respectively) and increased in non-pregnancy (9.05±0.71 IU/L and 187.8±13.3 pmol/L, respectively).Conclusion: Spontaneous pregnancy after sub-inguinal varicocelectomy is significantly affected by BMI, sperm concentration, progressive motility and morphology. The decrease of FSH may predict the spontaneous pregnancy outcome

Effects of Exposure to Flour dust on Respiratory Symptoms and Lung Function of Bakery Workers: a Case Control Study

Background: Many studies have shown that exposure to flour dust is associated with development of respiratory symptoms and varying degree of reduction in lung function. These depend on work environment and duration of exposure. There is no published data from Sudan where work conditions may be different. Objectives: This study was designed to assess the effect of exposure to flour dust on respiratory symptoms and lung function of bakery workers at a number of bakeries in Khartoum state. Methods: A total of 36 bakery workers who work for eight hours or more and 40 control subjects matched for age; sex; height; and area of residence were studied. Respiratory symptoms were evaluated using a structured questionnaire and lung function was measured using a portable spirometer. Results were compared using the paired t-test. Results: Daily work related respiratory symptoms were significantly increased in cases compared with controls. For those who worked at the bakeries for less than three years there were no significant differences in FEV1 or FVC; percent predicted when compared with controls. However; bakery workers who worked at the bakeries for three years or more have significantly lower FEV1 and FVC; percent predicted when compared with controls. Conclusions: Exposure to flour dust causes increased work related respiratory symptoms in bakery workers who work for eight hours or more. In these workers prolonged exposure to flour dust causes significant reduction in lung function as measured by FEV1 or FVC; percent predicted