Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

Background: Critical part of transfusion is effective screening of TTI, to reduce the risk of transmission is as safe as possible. The present study has undertaken to focus on seroprevalence of TTIs among both voluntary and replacement donors and also to project epidemiological data of TTIs in this community.Methods: This is a retrospective study conducted from January 2014 to December 2018. All blood samples collected from donors were screened for HIV, HBV, HCV, Syphilis and malaria according to blood bank policy. Before drawing blood, donors were asked to fill pre structured Blood bank questionnaire and consent form.Results: In this present 5-year study, total number of blood donor population was 54937, among them voluntary donors were 33891 and replacement donors were 21046. Out of 33891 voluntary donors, 33486(98.8%) were males and remaining 405(1.19%) were females. All replacement donors (21046) were males. The seroprevalence of HBV was highest, 1.82% (1003/54937) followed by HCV 0.31% (175/54937) in all the donors. The seropositivity for HIV is 0.23% (129/54937), for syphilis 0.04% (24/54937) and for malaria 0.01% (6/54937).Conclusions: National blood transfusion policy should be strengthening the standards and quality of screening across the country. For blood screening, resources and appropriate screening assays must be available at all health centres.

Panorama of neoplasms of upper GI tract: a 5 year research study.

Background: The diseases of the gastrointestinal tract (GIT) are the most common and leading cause of morbidity and mortality than the disorders of any other systems of the body. Gastrointestinal (GI) tract tumors are one of the most common cancers accounting for 11% of all cancers. Among these tumors, upper gastrointestinal tract malignancies are quite aggressive with a dismal prognosis. Malignant tumors are most common than benign. The most common carcinoma of the esophagus is Squamous cell carcinoma (SCC). Incidence of SCC is less than 5 per 100,000 populations in males and 1 per 100,000 populations in females. Gastric cancer was the second most common cancer in the World and 60% of them occurred in developing countries. The most common carcinoma of the Stomach is Adenocarcinoma. Aim & Objectives: To study the spectrum of neoplastic lesions of the upper gastrointestinal tract by the examination of endoscopic biopsies and surgically resected specimens. To determine the degree of severity of the malignancies by assessing the depth of invasion, Lymph nodal & Omental spread. Methods: The present study is both retrospective & prospective study for a period of 5 years from January 2007 to December 2011. The sample size includes all the endoscopic biopsies & surgically resected specimens of gastrointestinal tract received at Department of Pathology, S.V. Medical College, Tirupati. The study also obtained clearance from the ethical committee of the institution. The biopsy specimens thus obtained were fixed in 10% buffered neutral formalin. The sections were stained routinely with H & E. Special stains and IHC done wherever necessary. Results: we have received 120 specimens regarding the upper gastrointestinal system. Among these 120 specimens, 71 specimens were endoscopic biopsies & 49 specimens were surgically resected specimens. Out of 71 Endoscopic biopsies 28 biopsies were malignant among which 2 was esophagus and 26 were stomach. Out of 49 surgically resected specimens 1 was benign and 32 were malignant tumors. Out of 59 neoplasms of stomach there were single cases each of Sub mucosal Lipoma, Malignant lymphoma, GIST & 56 cases of Adenocarcinoma & its variants were noted. Conclusion: Most of the neoplasms are of stomach (97%). All the neoplasms are malignant except one benign lesion sub mucous lipoma of stomach. Most of the neoplasms of stomach were Adenocarcinoma (96.5%). Both tumors of esophagus were squamous cell carcinoma occurred after 50 years of age.

Volume of semen as a parameter of its quality.

A total of 1655 semen samples obtained from men who underwent initial semen analysis before enrolling for IVF-ET programme were analysed. The semen samples were categorized arbitrarily on the basis of volume as high (> 4.5 ml), normal (1.5-4.5 ml) and low (< 1.5 ml). The semen parameters studied vis-a-vis volume of the sample were viscosity, osmolality, motility, sperm count and morphology. The different volume groups were also compared to the overall quality of the sample. The study showed that high and low volume semen were associated with high incidence of spermatozoa exhibiting subfertile characteristics. Normal volume per se did not indicate the quality of the sample, however high and low volumes were indicators of semen of subfertile quality. There was an inverse correlation between osmolality and volume of semen sample. Thus the parameter 'volume' gives a rough estimate of the quality of the sample.

Incidence of abnormalities in sperm morphology as an indicator of its fertilizing potential.

A retrospective analysis was carried out to assess the correlation of sperm morphology with the occurrence of fertilization in vitro of human oocytes. Seventy women who were subjected to in vitro fertilization procedure were taken up for this study. The cytological smears of semen were evaluated for the morphological characteristics of spermatozoa. Instances where in vitro fertilization did not occur (group II) had significantly (P less than 0.001) higher morphological abnormalities (head defects) when compared with those where fertilization occurred in vitro (group I). The results indicate that evaluation of sperm morphology with special reference to head abnormalities has diagnostic potential in human in vitro fertilization.

Comparison of four different ovarian stimulation protocols in an in vitro fertilisation & embryo transfer programme.

Four different ovarian stimulation protocols were evaluated in an in vitro fertilisation and embryo transfer programme in 208 women (228 treatment cycles). In the rigid protocol (RP), 100 mg of clomiphene citrate (CC) was given from day 3 to day 7 of the menstrual cycle and 300 IU of human menopausal gonadotropin (hMG) was given from day 5 of the menstrual cycle. In the individualised protocol (IP) the same drugs and doses were used as in RP, but the day of initiation of CC depended on the length of the individual's menstrual cycle and hMG was administered from the last day of CC. In the programmed protocol (PP), ovarian function was suppressed with oral contraceptive pills (ethinyl estradiol 30 micrograms and norethisterone 1 mg) started on day 5 of the menstrual cycle for 45 to 70 days. Considering the last day of pill intake as day 0, CC was given for 5 days from day 5 and hMG (300 IU) from day 7. In the alternate day protocol (ADP), 100 mg of CC was administered from day 2 to day 6 and hMG (300 IU) was given on alternate days from day 2 to day 8 or day 10 of the cycle. In all the women, hCG (5000 IU) was administered when the diameter of at least 2 follicles was greater than or equal to 16 mm and estradiol levels were 300 pg/ml/dominant follicle. Patients not showing such a response were not treated further. The cardinal events of IVF-ET such as number of good responders, incidence of oocytes harvested, fertilised and embryos transferred per cycle were compared and it was concluded that the pregnancy rates were highest in women treated by the PP.

Scanning electron microscopy in the assessment of sperm morphology.

The advantages of using scanning electron microscope (SEM) vis-a-vis light microscope (LM) to assess sperm morphology was studied. The semen samples obtained from 15 fertile (group I) and 25 infertile (group II) men were processed by routine procedures for LM and SEM. The usually described sperm abnormalities were identifiable with greater resolution. Sperm abnormalities were significantly more in group II, as compared with group I (P less than 0.001) by both methods. Abnormalities of different regions, like thinning of midpiece, were scored higher in SEM than in LM. The abnormality of aggregation or retraction of mitochondrial sheath was clearly visible under SEM and missed by LM. Apart from detection of certain subtle abnormalities, SEM has advantages of rapid screening, accurate quantitation directly from the screen, zooming to higher magnification and automation.

Ultrastructure of spermatozoa & non spermatozoal cells in human semen in genital tract infections.

With a view to ascertain the possible etiology fo the morphological abnormalities seen in spermatozoa of semen from genital tract infections, 16 semen samples were studied. Samples were selected on the basis of each of them having 10-12 pus cells per high power field. Apart from routine semen analysis, the sperms were subjected to electron microscopic studies. Alterations in the ultrastructure of spermatozoa and non-spermatozoal constituents of the infected semen samples were studied. The possible etiology of a wide spectrum of abnormalities in semen found to be associated with genital infection is discussed.

Estimation of daily sperm production in rats and monkeys.

Daily sperm production in rats and monkeys were estimated by extended histometric method. Individual seminiferous tubules were separated, fixed, processed and embedded. Semi-thin sections were stained with toluidine blue and the different cell types quantitated with Chalkley's eye piece. The daily sperm production estimated was compared with that obtained by the homogenization method. The results indicate that daily sperm production obtained by both the methods were comparable. The present histometric method has an added advantage of requiring very small amount of biopsy material to give precise daily sperm production estimations.

Circadian and circannual changes in the testicular function of adult rhesus monkeys.

The endocrine and gametogenic status of the testes were studied in 9 healthy adult rhesus monkeys of proven fertility throughout a one-year period. Testosterone levels were estimated by radioimmunoassay in blood samples collected at 4 h intervals over a 24 h period once a month. Semen samples and testicular biopsies were also examined once a month. A well-defined circandian rhythm was evident in serum levels of testosterone. The rhythmicity was less pronounced in February and September. The 24 h mean levels of serum testosterone were high between the months of August to March and low in the months of May to July. All animals did not uniformly respond to electro-ejaculation in April and May. Semen volume and total number of spermatozoa were maximal between September and March and least from April to August. Testicular biopsies indicated that all stages of spermatogenesis were evident between September and March and the spermatogenic activity was less evident between April and August. The contents of Sertoli cells showed a seasonal cyclicity; they were laden with lipid droplets during April to August when spermatogenesis was quiescent and vacuolated during September to March when spermatogenesis was active. These studies indicate that the testing of contraceptive drugs needs to be restricted to months of September to March in male rhesus monkeys otherwise, it is possible that the naturally occurring reproductive quiscence may be attributed to the effect of the drug being tested. The data accrued from the present studies also provide quantitative information on circulating levels of testosterone which could be used as a reference background while evaluating the contraceptive drug-effects in male rhesus monkeys.

Ultrastractural features of the principal cell in the epididymis of the rhesus monkey.

The ultrastructural features of the principal cell in the epididymal epithelium of the monkey epididymis are suggestive of the cell carrying out a dual function of absorption and secretion. Both these functions occur on the luminal surface of the cell as well as on the lateral and basal aspects of the cell which face the intercellular spaces. Transmision Electron Microscopic studies of epididymal tissues following their impregnation with lanthanum nitrate indicated that the intercellular spaces are effectively sealed-off from the luminal space by the apically situated tight junctions between adjoining principal cells. The intercellular spaces are contiguous with the perivascular spaces of the subepithelial blood capillaries. It is suggested that the absorptive and secretory functions occuring on the apical surface of cells may be related to the creation of an appropriate intraluminal milieu for the maturation of spermatozoa while the occurrence of these functions in the intercellular spaces may represent an exchange of substances between the principal cells and the subepithelial capillaries.

Ultrastructural studies on the epididymal spermatozoa in the rhesus monkey.

Ultrastructural studies on the spermatozoa in different regions of the epididymis of the rhesus monkey have shown that the process of sperm maturation is associated with the caudad migration of the cytoplastmic droplet, a reduction in the volume of the cytoplasmic droplet, and an obvious wrinkling of the plasma membrane surrounding the head of the spermatozoa. These changes are completed by the time the spermatozoa reach the distal-middle segment of the epididymis. The present studies also indicate that spermatozoa are incorporated into the intraepithelial cells in the epidymis. This finding suggests that spermiophagy is a normal occurrence in the epidymis of rhesus monkey.

Light microscopic features of the rete testis, the vas efferens, the epididymis and the vas deferens in the adult rhesus monkey.

The present study was carried out to determine the detailed histological and cytological features of the excurrent ducts of the male reproductive system in the rhesus monkey. The excurrent ducts show a regional difference in their histological features. The use of some of these features as histological markers and their possible functional significance are discussed. The epithelial cells in the different components of the excurrent duct system possess cytological features which suggest their involvement in absorption and the secretion of different products into the lumen.