Prospects for the sustainability of delivering the basic package of health services in Afghanistan: a stakeholder analysis

This study explored the readiness of stakeholders in Afghanistan for sustaining delivery of the Basic Package of Health Services [BPHS] without external technical and financial assistance. A stakeholder analysis was applied using qualitative methods. Fifteen stakeholders were purposively drawn from the Afghanistan ministries of public health and finance, political representatives, development partners, nonprofit organizations and public health experts. Data were collected through in-depth interviews with the stakeholders and desk review of pertinent documents. We found that sustainability of the BPHS in Afghanistan is questionable as stakeholders are suboptimally organized to come up with effective alternatives. Uneven ownership and divisive positioning are bottlenecks to the evolution of a realistic continuation plan. Those with the most significant influence are lukewarm, while those who are most supportive have the least influence. Sustainability needs to be tackled at the start in designing the BPHS rather than in the wake of eventual donor withdrawal

Evaluation of aminoglycosides [gentamicin, neomycin, streptomycin] and fluoroquinolones [ofloxacin] antibiotics on spermatogenesis in rat

Gentamicin, Neomycin, Streptomycin and ofloxacin are synthetic antibacterial agent belonging to the family of aminoglycoside and fluoroquinolones antibiotics with a very broad spectrum against microbial pathogens, especially Gram-negative and urinary tract infectious diseases which nowadays have good effect in diseases treatment in more countries world-wide. The aim of this study was to see the effects of this drugs inducement, in Spermatogenesis cycle in rat. The fifty male wistar rat were selected and randomly divided into five groups; control [n=10] and test [n=40]. The test groups was received 5mg/kg [IP] Gentamicin, 50mg/kg [IP] Neomycin, 40mg/kg [IP] Streptomycin, and 72mg/kg [PO] ofloxacin daily for fourteenth day; however the control group just received vehicle [IP]. In fourteenth day the testis tissue of Rat in whole groups were removed and sperm was collected from epididymis then prepared for analysis. Light microsopic Obervation Showed that sperm cell count and viability as compared with compared with control group decreased significantly [p<0.001]. When compared with control group, percentage of sperm motility decreased significantly in all experimental except ofloxacin group [p>0.05]. Since in our study ofioxacin had only effect on sperm population and viability and hadn't any effect on sperm motility percentage, so it seems that using this antibiotic is safest more than others on sperm health parmeters

[ effect of pentoxifylline on motility and morphology of spermatozoa from epididymal and testicular samples of infertile men]

There are generally three factors involved in male infertility: low count, weak motility, and abnormal morphology of spermatozoa. Currently, it is impossible to improve the quality of sperm count and morphology in vitro. However, it may become possible to improve the sperm motility with the application of motility enhancer medicine. The objective of this study was to evaluate the effect of pentoxifylline[PX] on sperm motility and morphology of asthenozoospermic epididymal and testicular samples. The specimens were retrieved with percutaneous epididymal sperm aspiration [PESA] and testicular sperm extraction [TESE] from men with obstructive azoospermia. A total of 40 PESA and 40 TESE samples were allocated to this prospective study. Following preliminary evaluation, each sample was processed with swim up procedure and then divided into two aliquots of control [non -PX] and PX [3.5 mMPX]. Following 45 min of incubation at 37°C, the percentages of motility and normal morphology of spermatozoa were evaluated using Mackler chamber and papaniclau staining techinque, respectively. The mean sperm counts in the PESA and TESE groups were 7.4 +/- 7.3x10[6] and 2.43 +/- 1.3x10[6], respectively. The percentages of normal morphology in the above groups were 22.67 +/- 11.6 and 14.9 +/- 9.2 which were respectively changed to 23.2 +/- 15.7 and 9.5 +/- 1.9 with PX incubation. In addition, the percentage of control progressive motility in the PESA and TESE samples were 13.9 +/- 4.2% and 0.26 +/- 0.6% which were increased to 20.1 +/- 9.7% [p<0.001] and 0.95 +/- 0.03% [p<0.05]. These results strongly suggest that PX was successful in enhancing sperm motility particularly in the PESA group. It also did not have any significant side effect on sperm morphology. PX is considered to be safe and cheap, with easy application which may be used for improving the male infertility treatment program. With its dual role as motility enhancer and vitality detector of spermatozoa, it can be used safely for the ICSI treatment of severe cases of asthenozoospermia