Varicocele Surgery Improves Sperm Count in Infertile Oligospermic Patients and so Improves Fertility; A Study in a Tertiary Care Hospital

The objective of this study was to find out the role of varicocele surgery in oligospermic infertile patients. It was a prospective and descriptive study carried out in Surgical Unit-I, Abbasi Shaheed Hospital and Karachi Medical and Dental College (KMDC), Karachi from April 2004 to March 2014. In this study, all patients of infertility due to low sperm count having bilateral varicocele were included while those patients having azoospermia or patients with unilateral varicocele were excluded. All patients were clinically assessed for bilateral varicocele and confirmed by ultrasonography of scrotum and relevant investigations were done. Patients were prepared for varicocele surgery and ligation of pampiniform plexus done. Semenanalysis were done during follow up and results were analyzed on SPSS version 14. Total fifty seven patients (n=57) were included in which age range was 20 to 30 years in 33.3%, 31 to 40 years in 42.1%, 41 to 50 years in 19.3% and 51 years to onwards in 05.3% patients only. Chronic smoking was found in 68.4% patients while 31.6% were nonsmokers. Normal testes was found in 77.19% while 22.81% had smaller (atrophied) testes. Very low sperm count was in 15.79%, 50.88% had low sperm count and 33.33% had near normal sperm count. All patients were operated for bilateral varicocele and discharged. Follow-up semen analysis showed improvement and semen analysis became normal in 19.3% after six months, 21.05% after nine months and 36.84% after one year of surgery while 22.81% had no improvement even after one year of surgery. Thus, patients with bilateral varicocele having low sperm count showed improvement in sperm count after varicocele surgery and so infertile patients may become fertile after varicocele surgery.

Stenting of Iliac Artery through Brachial Approach.

In some cases the iliac artery occlusive disease cannot be approached through standard access. The preferred access sites are the ipsilateral retrograde femoral and the contralateral antegrade cross-over, although occasionally these approaches do not allow an effective engagement of the lesion, especially when there is a total occlusion or complex aortoiliac lesion. We are reporting a case of iliac artery stenting through brachial approach.This technique is safe and effective. It provides enough support for stiff balloon or stent catheter to be advanced through this long sheath.

Platelet activating factor-induced aggregation of calf platelets: apparent positive cooperativity in the kinetics and non competitive inhibition by diltiazem.

Aggregation of calf platelets by platelet activating factor was characterized by a spectrophotometric method. The aggregation kinetics of both platelet-rich plasma and purified platelets showed concave up double-reciprocal plots and linear Hill plots with h > 1 (1·7 ± 02) consistent with positive cooperativity. Comparable values of maximum rates of aggregation (R) were obtained with platelet-rich plasma (0·25 ± 0·08) and purified platelets (0·28 ± 0.18) but the half-maximal saturation concentration (S0.5) differed greatly between platelet-rich plasma (6 ± 3 nM) and purified platelets (0·28 ± 0·18 nM). An Arrhenius activation energy of 21 ± 2 kcal/mol was found for aggregation of purified platelets. Diltiazem was inhibitory with half-maximal inhibitory concentration (I0·5) of 4 M but the inhibition was not competitive. Diltiazem inhibited rates but not the extent of shape-change. The receptor-antagonist and sulphydryl reagent N-ethylmaleimide and the platelet antagonistic omega-3-fatty acid, 5,8,11,14,17-eicosa pentaenoic acid, inhibited both rates and extent of shape-change reactions and inhibited aggregation competitively (I0.5 ~ 5 μM). Eicosa pentaenoic acid at > 25 μM could abolish shape-change reactions and at 50 μM served as an activator of platelets and the activation was enhanced by aspirin (1 mM). Although N-ethylmaleimide at > 20 μM could also induce platelet activation it failed to induce aggregation and aspirin had no effect on the shape-change reactions induced by it.

Competitive inhibition of hydrogen peroxide-induced aggregation of calf platelets by prostaglandin H2/thromboxane A2 receptor ligands.

Hydrogen peroxide (H2O2)-induced aggregation of calf platelets and its modification by agents with specific properties were characterized employing a spectrophotometric assay. An Arrhenius activation energy of 20 ± 1 kcal/mol was found in the temperature range of 25°-36°C. Rate inhibition occurred on either side of this temperature range, and under anaerobic conditions. Exogenous Ca2+ ions were not required but Ca2+ ions, at 1 mM-concentration, optimally increased rates and extent of aggregation at suboptimal H2O2 concentrations but only extent of aggregation at optimal H2O2 concentrations. Ba2+, Sr2+, Cd2+, Mn2+ and Ni2+ ions (1 mM) and Zn2+, Pb2+ and Hg2+ ions (10 mM) were inhibitory. The cyclo-oxygenase inhibitor, indomethacin (10- 30 mM) exerted only mild inhibition by a competitive mechanism. Another cyclooxygenase inhibitor, aspirin, functioned to increase aggregation. Ligands acting directly at the prostaglandin H2/thromboxane A, receptor (5Z. 9, 11, 13E, 15(S) 15-hydroxy 9(11) epoxy methano prosta 5, 13-dien-1-oic acid, pinane thromboxane A2, arachidonic acid, eicosapentaenoic acid, and N-ethylmaleimide) functioned as competitive inhibitors. Another platelet-activating sulphydryl reagent, thimerosal, also inhibited competitively while the protein kinase C inhibitor, sphingosine, and the protein kinase C modulator, Zn2+ ions, inhibited by different mechanisms. The results indicate direct action of H2O2 at the prostaglandin H2/thromboxane A2 receptor, possibly its sulphydryls, to activate the protein kinase C pathway, independently of cyclo-oxygenase products. The results underscored the power of the kinetic approach for investigating mechanisms of platelet activation.

Adenosine and ATP: mutually exclusive modifiers of the kinetics of ADP-induced aggregation of calf-platelets.

Modulations of initial rate kinetics of ADP-induced aggregation of citrated calf platelet-rich plasma by adenosine and ATP were investigated employing a spectrophotometric platelet aggregation assay. The data were analysed according to the tenets of sequential shape-change and interaction model of aggregation. Adenosine and ATP increased the slopes and intercepts of double-reciprocal plots of ADP-aggregation kinetics. Examination of their slope and intercept effects together with their effects individually and in combination, on aggregation rates, suggested that adenosine and ATP acted at multiple, nonoverlapping, sites.

N-[2-Naphthyl]-glycine hydrazide, a potent inhibitor of DNAdependent RNA polymerase of Mycobacterium tuberculosis H37Rv.

N-[2-Naphthyl]-glycine hydrazide has been shown for the first time as a potent inhibitor of the DNA-dependent RNA polymerase (EC 2.7.7.6) of Mycobacterium tuberculosis H37Rv. At a concentration of 10–9 M, the compound shows maximum inhibition of the enzyme, the inhibition being less at higher concentrations. It is suggested that the novel type of inhibition pattern may be due to hydrophobic interactions occurring between the molecules of the compound at higher concentrations. The finding that there is a shift in the λmax of the compound could also account for this phenomenon. The effect of this compound was also tested on DNA-dependent RNA polymerases from an eukaryotic fungus, Microsporum canis. At a concentration of 10–9 Μ it inhibits RNA polymerase II (32%) but not RNA polymerases I and III.

A rapid and gentle method for the salt extraction of chromatin core histones H2A, H2B, H3 and H4 from rat liver nuclei.

A complex of histones H2A, H2B, H3 and H4 has been isolated from purified rat liver nuclei by a method which is both gentle and rapid. Nuclei were homogenised in 0·25 Μ sucrose and the residual nuclear material obtained after centrifligation was adsorbed on calcium phosphate gel. After removing histone H1 from the adsorbed material by washing with 1M NaCl in 25 mM sodium phos phate buffer, pH 6·0, histones H2A, H2B, H3 and H4 were eluted together, with 2 Μ NaCl in 25 mM sodium phosphate buffer, pH 7 · 0. The core histones so obtained migrated as a single sharp band on polyacrylamide gel electrophoresis under non denaturing conditions. Fractionation of the freshly prepared core histones on a Sephadex G 100 column yielded two major protein peaks. The peak having the larger elution volume contained histones H2A and H2B in equal amounts while the peak with the smaller elution volume contained all the four histones. Histones H3 and H4 were present in larger proportions in the second peak.