ABSTRACT
Background: The subtelomeric rearrangements are increasingly being investigated in cases of idiopathic intellectual disabilities [ID] and congenital abnormalities [CA] but are also thought to be responsible for unexplained recurrent miscarriage [RM]. Such rearrangements can go unnoticed through conventional cytogenetic techniques and are undetectable even with high-resolution molecular cytogenetic techniques such as array comparative genomic hybridization [aCGH], especially when DNA of the stillbirth or families are not available. The aim of the study is to evaluate the rate of subtelomeric rearrangements in patients with RM
Materials and Methods: In this cross-sectional study, fluorescent in situ hybridization [FISH], based on ToTelVysion telomeric probes, was undertaken for 21 clinically normal couples exhibiting a "normal" karyotype with at least two abortions. Approximately 62% had RM with a history of stillbirth or CA/ID while the other 38% had only RM
Results: FISH detected one cryptic rearrangement between chromosomes 3q and 4p in the female partner of a couple [III:4] [46,XX,ish t[3;4][q28-,p16+;p16-,q28+][D3S4559+,D3S4560-,D4S3359+; D3S4560+, D4S3359- ,D4S2930+]] who presented a history of RM and family history of ID and CA. Analysis of the other family members of the woman showed that her sisters [III:6 and III:11] and brother [III:8] were also carriers of the same subtelomeric translocation t[3;4][q28;p16]
Conclusion: We conclude that subtelomeric FISH should be undertaken in couples with RM especially those who not only have abortions but also have had at least one child with ID and/or CA, or other clinically recognizable syndromes. For balanced and cryptic anomalies, subtelomeric FISH still remains the most suitable and effective tool in characterising such chromosomal rearrangements in RM couples
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Acute coronary artery syndrome [ACS] is the major cause of mortality in Pakistan with genetic and environmental influence on the incidence of the disease. This case-control study was designed to find out if a correlation is existing between ACS and single nucleotide polymorphisms [SNPs] in DNA repair genes XPD [at codon 751, rs 13181 [Lys to Gln]] and XRCC1 [at codon 399, rs25487 [Arg to Gln]; 280, rs25489 [Arg to His] and 194, rs 1799782 [Arg to Trp]] either individually or in various combination with each other [haplotype analysis]. The objective of this study was to find out the association of various studied risk factors and serum lipid profile of the subjects with the disease, if any. PCR-RFLP method was used to determine genotype at specific codon in 221 subjects [115 ACS patients and 106 healthy controls] from Southern Punjab population. Genotypic and allelic frequency distribution among the cases and controls revealed that all the studied SNPs were not individually associated with the ACS. Haplotype analysis revealed that subjects having wild type combination of all three XRCC1 SNPs had greater susceptibility to ACS than any other studied genotypic combinations. Analysis of risk factors revealed that hypertension [P<0.001], age [P=0.05], education [P<0.001], gender [P<0.001], family history [P=0.005], smoking habit [P=0.002] and diabetes [P<0.001] were significantly associated with the incidence of ACS. Serum lipid profile analysis indicated that cholesterol level was significantly higher [P=0.048] in patients [161.5mg/dL] than controls [142.1mg/dL] while triglyceride remained unaffected [P=0.87] when compared between the two treatments
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Objective: This study aimed to determine the prevalence of intestinal parasitic infections among school children in rural and urban areas of the Ibb region in Yemen
Methods: In this cross-sectional study, participants were randomly recruited from both urban and rural areas. A total of 258 stool specimens from 112 boys and 146 girls were analysed. All samples were examined using both direct and concentration methods to identify microscopically possible diagnostic stages of intestinal parasites
Results: Of the 258 samples studied, 148 students were found to be positive for at least one parasite infection with an overall estimated prevalence of 57.4%. Of the 138 children from urban areas, 89 [64.5%] were found to be infected, whereas 59/120 [49.2%] students from rural areas were infected. The infection was statistically higher in urban areas [X[2] = 6.164, P = 0.013]. The infection rate was highest among the age group 10-11 years [31.8%] followed by 12-13 years [28.4%]. Infection rates of 23.6% and 16.2% were recorded among 8- to 9-year-olds and 14- to 15-year-olds, respectively. The distributions of parasites among school children detected in descending order were: Entameba histolytica [33.7%], Giardia lamblia [23.6%], Ascaris lumbricoides [14.3%], Trichuris trichiura [9.3%], Hymenolepis nana [6.2%], Schistosoma mansoni [3.1%], Ancylostoma duodenale [1.2%], Enterobius vermicularis [0.8%] and Strongyloides stercoralis [0.8%]
Conclusions: This study showed that infection by intestinal parasites is prevalent among school children and can be a crucial public health problem. This study emphasizes the need for public health interventions to tackle this problem
Subject(s)
Humans , Male , Female , Child , Adolescent , Prevalence , Public Health , Schools , Child , Rural Population , Urban Population , Cross-Sectional StudiesABSTRACT
Objective: To evaluate the association of BMI and risk factors of coronary artery disease in patients presenting with chest pain in outdoor cardiology department
Study Design: Descriptive / comparative study
Place and Duration of Study: This study was conducted at the Outdoor Cardiology Department of Nishter Hospital Multan from May 2016 to August 2016
Materials and Methods: All patients who presented with complain of chest pain in outdoor cardiology department were included. Patients were divided into three groups on the basis of BMI
Results: There were 42.0% females patients in obese group as compared to only 12.0% and 20.0% in normal weight and overweight groups [p-value 0.002 Mean age of patients at the time of presentation was significantly less in obese group 49.38 +/- 6.56 years, whereas in normal and overweight patients mean age was 56.60 +/- 9.29 years and 54.84 +/- 9.94 years respectively [p-value <0.001]. There was no patient with age more than 60 years in obese group, 47.5% in overweight group and 52.5% in normal weight group [p-value <0.001]
Conclusion: Obesity is an independent risk factor for the early development of coronary artery disease [CAD] and increased risk of hypertension in early age
ABSTRACT
Objective: Heart failure [HF] is a chronic disease usually associated with psychological issues especially anxiety/depression despite of medical treatments. Aim of our research data study was the estimation of level of depression among admitted CHF patients in Nishtar Hospital and to find an association of various clinical parameters with depression
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Cardiology Department of Nishtar Medical College and Hospital Multan from March 2016 to August 2016
Materials and Methods: 400 patients with systolic HF were divide according to the NYHA heart failure classification system. The level of depression was assessed by using Beck's Depression Inventory questionnaire. The patients with a previous history of major depressive disease, psychological diseases, or chronic other severe ailments were excluded. To assess the relationship between variables the chi square test was applied to data
Results: 76 patients in group B of depression were hypertensive and in group A of depression 85 were hypertensive with p=0.04 that is significant i.e. p<0.05. The high depression of group B was much more common in heart failure group B with 53 people having severe depression and 96 group A CHF patients had mild depression with p=0.05 that is statistically significant. Similarly, 94 mildly depressed people were in joint family system of group J and 56 severely depressed patients were in group S with p=0.03 that is highly significant
Conclusion: Depression is very common among CHF patients who are living alone or with spouse only. And severe depression level is more common than mild/moderate depression at higher NYHA classes of CHF
ABSTRACT
Objective: To determine the frequency of acute ST elevation myocardial infarction and various reasons of pre-hospital delay in early morning hours
Study Design: Cross-sectional survey
Place and Duration of Study: This study was conducted in the department of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan from 18th September 2012 to 17th March 2013
Materials and Methods: 164 patients of either sex giving mid-section torment in right on time morning were incorporated in this study. The meeting secured the patients' indications, the season of onset of side effects, the consequent occasions and the past history. Entry time short the season of side effects onset was ascertained as pre-healing center postponement and it was computed in hours
Results: 164 patients were included in the study. The mean age of patients was 54.85 years with standard deviation of 10.684 years. 77 [46.95%] patients were male and 87 [53.05%] patients were female.Mean delay of patientswith chest pain was 3.49 hours with standard deviation of 1.777 hours. 96 patients had pre-hospital delay of more than 3 hours while 68 patients had no pre-hospital delay. 130 patients presenting with morning chest pain had ST elevation MI while 34 patients did not have ST elevationMI
Conclusion: In conclusion, onset of symptoms at night especially in morning causes more prolonged delay in hospital arrival because transport means and medical helps are beyond reach at these times
ABSTRACT
Background: Neuroblastoma [NB] shows a complex combination of genetic aberrations. Some of them represent poor genetic prognosis factors that require specific and intensive chemotherapy. MYCN amplification consists of the major bad outcome prognostic factor, it is indeed frequently observed in aggressive neuroblastomas. To date different methods are used for MYCN status detection
Objectives: The primary aim of our study was to provide a critical assessment of MYCN status using 2 molecular techniques CISH and MLPA. We also focused on the correlation between neuroblastoma genetic markers and patient's clinical course among 15 Tunisian patients
Methods: we developed a descriptive study that includes 15 pediatric Tunisian patients referred to our laboratory from 2004 to 2011. We reported the analysis of fresh and FFPE NB tumors tissues
Results:No significant correlation was found between COG grade and patients overall survival. Assessment of NMYC gene copy number by kappa statistic test revealed high concordance between CISH and MLPA tests [kappa coefficient = 0.02]
Conclusion: Despite misdiagnosing of MYCN status fewer than 5 copies, MLPA remains an effective molecular technique that enables a large panel of genomic aberrations screening. Thus combining CISH and MLPA is an effective molecular approach adopted in our laboratory. Our results allow pediatric oncologists to set up the first Neuroblastoma therapeutic strategy based on molecular markers in Tunisia
ABSTRACT
Acute Coronary Syndrome [ACS] is the most common disease and cause of mortality in both genders across the world and certain risk factors i.e. age, gender, smoking, diabetes, hypertension, drugs usage, weight etc are known to be associated with the disease. The aim of this study was to find if there is any correlation exists between ACS and hereditary genetic defect in endothelial nitric oxide synthase [ecNOS] gene as eNOS generates Nitric oxide in blood vessels and regulates the vascular tone hence directly affecting the cardiovascular function. Single nucleotide polymorphism [SNP] [Glu 298 Asp] in ecNOS was determined in 280 subjects, from Southern Punjab [in Pakistan] population, including [160 ACS patients and 120 healthy controls] by PCR-RFLP method and genotype was correlated with various risk factors as well as with serum cholesterol and triglyceride levels. Our results indicated that the genotype Glu 298 Asp was not associated with ACS but when various studied parameters were compared among patients suffering from various forms of ACS and their healthy controls, it was observed that age [45-55 years] [P = 0.05], gender [male] [P < 0.001], education [P<0.001], family history [P=0.03], hypertension [P<0.001], diabetes [P<0.01] and smoking habit [P = 0.03] were the significantly different parameters among them and may be associated with the incidence of cardiovascular disease. Cholesterol [161.5 +/- 79 mg/dL] level was found to be higher in patients [P = 0.04] than controls while triglyceride remained unaffected [P = 0.87] in both groups
ABSTRACT
Recently circadian clock genes have been identified in humans but information regarding their expression has remained very limited. The evaluation of circadian variations in the expression of clock genes in humans seems to be a major importance both from a fundamental point of view as a diagnostic and therapeutic perspective. In this context, several works including ours have described the fluctuation of clock genes. Describing rhythmic expression of clock genes in intensive care units patients during 24h and we tried to determine the effect of the absence of synchronizers such as light/ dark cycle on these rhythms. 15 patients received care in private room in intensive care units in the hospital Sahloul [5 comatous and 10 non comatous patients]. For RNA isolation we used peripheral blood mononuclear cells which represent an ideal material to investigate non-invasively the human clock at the molecular level. In the present study, we noticed that clock genes mRNA exhibit a circadian expression in comatose patients, while the rhythmicity of some studied genes disappeared in non-comatose patients. The disturbance of the rhythmic fluctuation of the clock genes could be the result of the effect of surgery on some biological rhythms as it could be explained by the lack of synchronizers in intensive care units such as light/dark cycle
ABSTRACT
MODY [Maturity-onset diabetes of the young], a dominantly inherited form of early-onset diabetes, is clinically and genetically heterogeneous with more than ten genetic subtypes described worldwide. To evaluate the possible existence of MODY in 12 young diabetic Tunisian patients by searching for mutations in the most prevalent MODY genes. Twelve patients with diabetes in 2-to-3 generations, all diagnosed before age 31, were screened for mutations and deletions in HNF1A, HNF4A, INS, IPF1, NEUROD1 and GCK genes by Sanger sequencing and by Multiplex ligation-dependent probe amplification assay. The patients had no evidence of autoimmunity and a mean age at diabetes diagnosis of 25.66 +/- 3.96 years with severe overt diabetes [fasting glycaemia: 10.91 +/- 3.55 mmol/ l; HbA1c: 10.46 +/- 3.31%]. Two subjects were initially treated with insulin. On the ten initially treated with OHA or on diet, eight converted to insulin therapy [within 3 months to 20 years]. Molecular analysis showed only one missense HNF4A mutation [I453V] in one family. No mutations in the studied genes were detected in the other patients. A molecular defect in known MODY genes has been excluded in 11 patients with early-onset diabetes suggesting that other genetic causes may explain diabetes in these families. In such cases, new generation sequencing approaches may be well appropriate to identify specific molecular etiologies from extended families and to establish a strategy of molecular diagnostic of MODY in Tunisia
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To find out the prevalence of malocclusion in patients visiting orthodontic department of Lahore medical and dental college [LMDC]. It is a cross sectional study. Orthodontic department, Lahore medical and dental College. Lahore. Malocclusion was clinically examined by using Angle's classification in 1143 patients [708 girls and 435 boys]. Class I malocclusion was found in 23.27% of the total sample. Class II malocclusion was found in 53.19% and Class III malocclusion in 8.66% of sample. No statistically significant differences were found in distribution of malocclusion between males and females. The study revealed that Class II malocclusion predominated among patients visiting orthodontic department of LMDC
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To compare the acute anaphylactic reactions of ionic and nonionic contrasts in patients undergoing coronary angiogram. Experimental study. This study was conducted in Catheterization Laboratory of Punjab Institute of Cardiology, Lahore from 28th September 2007 to 27th March 2008. 200 patients undergoing coronary angiogram, admitted in Punjab institute of Cardiology Lahore through outpatient department [OPD] and emergency ward were included. The socio demographic information like name, age sex and address were recorded. After taking informed consent, the patients were divided into two groups by using random numbers table before the procedure. First group received ionic and the second group received nonionic dye. All patients will undergo coronary angiogram and anaphylactic reactions were recorded. Out of 200 patients 153 [76.5%] were male and 47 [23.5%] were female. Age range was 32-75 yrs with mean age of 53.94 +/- 10.07 of study population. The study population was divided into two equal groups. First group 100 patients received Ionic dye while second group 100 patients received Non ionic dye. Anaphylactic complications during coronary angiogram were more common in patients who received ionic contrast as compared to non ionic contrast group. Anaphylactic complications during coronary angiogram were more common with ionic dye as compared to non ionic contrast
Subject(s)
Humans , Male , Female , Coronary Angiography , Anaphylaxis , Coronary Artery DiseaseABSTRACT
To compare in-hospital complications in terms of complete heart block and mortality in patients of inferior wall myocardial infarction with or without right ventricular infarction and to see the frequency of right ventricle infarction in patients of inferior wall myocardial infarction. Cross-sectional comparative study. The study was conducted at Chaudary Pervez Elahi Institute of Cardiology, Multan from 7th August 2009 to 6th February 2010. 73 patients with inferior ST-segment elevation myocardial infarction were distributed into two groups; one with IWMI only and second with IWMI with RV infarction. Patients with prior MI, pre-exiting heart failure, valvular heart disease, pericardial disease, acute pulmonary embolism, significant pulmonary diseases were excluded from the study. The data was analyzed by using software SPSS. The difference in frequencies of complications in two groups was compared using chi square test and a p value of <0.05 was considered significant. Mean age was 51.95 +/- 11.8 years in group 1 and 54.17 +/- 12.0 years in group 2. Patients in group 2 had more complications as compared to group 1. The incidence of Complete AV block was 7 [38%] in group 2 vs. 3 [5%] in group 1 [p=<0.001]. The incidence of right ventricular infarction in patients of inferior wall myocardial infarction was noted to be 26%. RVI results in increase in the frequency of complete heart block and mortality in patients of inferior wall myocardial infarction with right ventricular infarction and the incidence of right ventricular infarction in inferior wall MI was 26%
Subject(s)
Humans , Male , Female , Inferior Wall Myocardial Infarction/mortality , Myocardial Infarction/complications , Myocardial Infarction/mortality , Mortality , Heart Block , Cross-Sectional StudiesABSTRACT
evaluation of our experience in assisted fertilization by ICSI with analysis of prognostic factors. retrospective study of 199 cycles of ICSI during a 2 years and half period between September 2001 and February 2004. The procedure of ICSI included several stages: collection and preparation of the semen, stake in culture of oocytes, removing of cumulus cells and microinjection of oocytes, control of the fertilization and embryo transfer respectively 18 to 22 hours and 48 hours after the microinjection. the mean age of the patients was 32,4 years and the mean duration of infertility was 7 years. The mean fertilization rate was 50%. The mean number of embryos transferred was 2.46. We got 41 pregnancies of which 36 were clinical pregnancies [87.8%]. The pregnancy rate was 26.1% by transfer and 21% by retrieval. The women age was the first prognostic factor of ICSI. The pregnancy rate was 27% before the age of 35 years, decreases with age and annul himself after 40 years [P=0.02]. The other prognostic factor was the number of 4 cells embryos transferred. The pregnancy rate increases with significant way with the number of 4 cells embryos transferred: 15% after transfer of only one embryo versus 43% after transfer of 3 embryos or more [P=0.04]. The ICSI prognostic has not been influenced with significant way by the origin or the sperm mobility, by the duration of infertility and by the total number of embryos transferred. the ICSI represents currently the treatment of choice of couple having extreme spermatic changes. The results of our study are comparable to those reported in the literature. The women age and the number of 4 cells embryos transferred are the main factors predicting of the ICSI prognostic
Subject(s)
Humans , Male , Female , Pregnancy Rate , Sperm Injections, Intracytoplasmic/methods , Fertilization in Vitro , Infertility, Male/therapy , Retrospective Studies , Oocyte Retrieval , Risk Factors , Treatment Outcome , PrognosisABSTRACT
Corticotomy found to be effective in accelerating orthodontic treatment. The most important factors in the success of this technique is proper case selection and careful surgical and orthodontic treatment. Corticotomy facilitated orthodontics advocated for comprehensive fixed orthodontic appliances in conjunction with full thickness flaps and labial and lingual corticotomies around teeth to be moved. Bone graft should be applied directly over the bone cuts and the flap sutured in place. Tooth movement should be initiated two weeks after the surgery, and every two weeks thereafter by activation of the orthodontic appliance. Orthodontic treatment time with this technique will be reduced to one-third the time of conventional orthodontics. Alveolar augmentation of labial and lingual cortical plates were used in an effort to enhance and strengthen the periodontium, reasoning that the addition of bone to alveolar housing of the teeth, using modern bone grafting techniques, ensures root coverage as the dental arch expanded. Corticotomy facilitated orthodontics is promising procedure but only few cases were reported in the literature. Controlled clinical and histological studies are needed to understand the biology of tooth movement with this procedure, the effect on teeth and bone, post-retention stability, measuring the volume of mature bone formation, and determining the status of the periodontium and roots after treatment
Subject(s)
Humans , Malocclusion/surgery , Alveolar Process/surgery , Bony Callus , Maxilla/surgery , Tooth Movement Techniques/methods , OsteotomyABSTRACT
It is current opinion that concealed and manifest accessory pathways are indistinguishable with respect to their location, and contribution to orthodromic reciprocating tachycardia This study aimed at comparing the clinical and Electrophysiological characteristics of concealed and manifest accessory pathways, assessment of immediate results and complications of radiofrequency ablation and detection of the recurrence rates of accessory pathways after radiofrequency ablation. This study was carried out in National Heart Institute and Zagazig University Hospital and included 37 patients that were referred because of symptomatic supraventricular tachycardia [SVT] refractory to medical treatment. They were divided into two groups: Group 1; twenty two patients with manifest accessory pathway on resting ECG and Group II; fifteen patients were proven retrogradly in the electrophysiological study [BPS] to have concealed pathway after exclusion of patients with AVNRT. Patients with more than one accessory pathway, Accessory pathway and associated SVT due to other mechanisms were excluded from the sturdy. All patients in both groups were subjected to Full history taking, Complete general and local examination of the heart, twelve lead surface ECG, Echo-Doppler Study and electrophysiological study to diagnose the mechanism of tachycardia and to localize the accessory pathway and radiofrequency ablation of accessory pathway. Then follow up was done to the patients for the next 6 months on regular basis in the outpatient clinic for recurrence of symptoms, resting ECG for resumed manifest pre-excitation, documented attacks of tachycardia, need for antiarrhythmic and need for redo. Symptoms pattern did not differ significantly between the two studied groups, with palpitation occurred in 100% in both groups, dizziness 40.4% in group I and 46.6% in group 11, syncope 18.18% in group I and 6.66% in group 11, dyspnea 27.27% in group I and 26.66% in group II, and sweating 18.18% in group land 13.33% in group II. Palpitation was the most common presenting symptom in both groups. Accessory pathway mediated tachycardia caused significantly higher rate of hospitalization in group II, There was no associated cardiac disease in any of our patients. We did not find any patient with accessory pathway and congenital heart disease. AVRT was correctly diagnosed in 8 patients [53%] in group II. The success of radiofrequency ablation of accessory pathways depends on accurate localization of accessory pathway. In our study 91% of group II patients had orthodromic tachycardia and 9% had antidromic tachycardia and 100% of group II patients had orthodromic tachycardia. Radiofrequency ablation was attempted in 21 patients in group I. In group II RF ablation was attempted in all patients. The acute success was comparable in both groups with no significant difference. In group I the acute success was 90% while in group II it was 85.5%. Complications in our study were met with in group I with one patient developed VF during catheter ablation, one patient developed RBBB, one patient had complete heart block necessitated insertion of permanent pacemaker, and one patient had deep vein thrombosis, and in group II one patient developed complete heart block, and one patient had deep vein thrombosis. The recurrence rate was 9% in group I while it was 6.6% in group H with non significant difference in both groups. Patients with concealed accessory pathway are older, has longer history of arrhythmia, and more frequent hospitalization than patients with manifest AR. Radiofrequency ablation is safe and effective therapy for AP mediated tachycardia with comparable success, complications, and recurrence in manifest and concealed AP
Subject(s)
Humans , Male , Female , Catheter Ablation/methods , Echocardiography, Doppler , Signs and Symptoms , Follow-Up StudiesABSTRACT
Between 1989 and 1995, 42 cases with acute lymphoblastic leukemia [18 males and 24 females] were diagnosed in our institution. Median age was 38.5 years [range, 16-88 years]. Leukocyte count was more than 30.10 9/l in 54 percent of cases. According to the French-American-British [FAB] criteria, 67 percent were classified L1 and 33 percent L2. Sixteen patients were treated with 12LA80 protocol, 14 patients with LALA 85 protocol, 6 patients with LALA 87 protocol and 6 patients with EORTC protocol. Complete remission was achieved in 22 cases [52 percent], 8 cases [20 percent] failed to respond and 12 [28 percent] died during induction. Relapse was observed in 10 cases. The 4-year survival rate was 28 percent confirming the worse prognosis of this leukemia when treated with standard chemotherapy
Subject(s)
Humans , Male , Female , Retrospective Studies , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Precursor Cell Lymphoblastic Leukemia-Lymphoma , AdultABSTRACT
Between 1989 and 1996, 40 cases with acute leukemia [16 males and 24 females] were diagnosed in out institution. Median age was 65 years [range, 56- 88 years]. Leukocyte count was more than 30.109/1 in 42 percent of cases. According to the French-American-British [FAB] criteria, 11 cases were classified lymphoblastic and 29 myeloblastic. Sixteen patients have received palliative treatment because of there age and there bad performance status. Only 24 patients have received curative treatment. Complete remission was achieved in 12 cases [50 percent], 5 cases [20 percent] failed to respond and 7 [30 percent] died during induction. Relapse was observed in 8 cases. The 2-year survival rate was 10 percent confirming the worse prognosis of the acute leukemia in elderly
Subject(s)
Humans , Male , Female , Acute Disease , Leukemia/classification , Leukemia/therapy , AgedABSTRACT
In this study, concerning 86 patients submitted to surgical exploration for sterility, has been achieved with a double objective to determines the precise histological nature of the lesions of the sperm ducts mainly of the epididymis and determine the etiological diagnosis of the epididymal obstruction. We've showen that whatever the level of the acquired obstruction of the epididymis, it will lead to the formation of an inflammatory home and to a situation combining the lessening of light, stase and massive arrival of spermiophage of destroying almost completely the spermatozoa. The simultaneous consideration of the 2 values of the <-glucosidase and the plasma FSH permit of reducing the mistakes in interpreting the origin of azoospermia. However we have produced evidence of diagnostic traps corresponding to a fibrose of rete testis where all the biological parameters are normal. W've showen that, there is a correlation between the presence of epididymal pathology and a drop in epididymal markers which can be found in severe oligospermia [which can be epididymal in origin and not testicular], also when there is non abnormalities in the spermogramm. This last situation can occur in " invisible" abnormalities of sperm maturation in the epididymis