Histomorphological patterns of testicular biopsies in azoospermic infertile males from a tertiary care unit of Pakistan

The objective of this study was to find out the most prevalent histological phenotype in azoospermic testis in those infertile men who presented with lab diagnosis of azoospermia and to compare our data with international studies. Cross Sectional Hospital Based Study. This study was conducted at Anatomy Department, SMU, Karachi for duration of one year from January 2010 till January 2011. This study was carried out in 100 men with azoospermia, going for a trial of ICSI. All underwent Testicular Sperm Extraction [TESE] for the retrieval of sperm for ICSI and for histopathological diagnosis. The mean age of the studied group was 36.64 +/- 5.217 years with 33.62 years as the lower limit and 35.66 years as the upper limit of 95% confidence interval. Body mass index was also calculated after height and weight measurement, which was observed as 28.22 +/- 7.12 kg/m[2] with 26.83 as the lower limit and 29.61 as the upper limit of 95% of confidence interval. The microscopic assessment of testicular biopsy showed that normal spermatogenesis was found to be in 25% of cases, showing normal tubular diameter with the presence of all stages of spermatogenesis. 31% of testicular biopsies showed hypo-spermatogenesis, characterized by reduced population of germ cells seen in the tubules and alteration in the order of spermatogenesis. Maturation arrest was seen in 17% of cases, evident by a halt of maturation sequence, at the stage of primary spermatocyte. Abundant cells in division were visible but no spermatid or spermatozoa were seen. Sertoli cell only was apparent in 17% of cases in which the tubules were populated with by only sertoli cells with the complete absence of germ cells. Generalized fibrosis was seen in 13% of cases which showed the atrophic tubules had a thickened, convoluted basement membrane with a hyaline appearance surrounding a lumen obliterated by fibrous tissue. Hypospermatogenesis was found to be the commonest pattern in testicular biopsies of studied population. This study supports the recommendation of bilateral testicular biopsies when investigating male infertility

Toxic effects of lead on the germinal epithelium in male albino rats

To determine the toxic effects of lead on the germinal epithelium of testes of albino rat. Experimental study. Basic Medical Sciences Institute. Jinnah Postgraduate Medical Centre, Karachi, from August 2003 to December 2005. Forty adult Albino rats selected for the study were divided into two groups; group A, received injection normal saline 1 ml intraperitoneally daily for eight weeks. Group B received lead chloride in a dose of 10 mg / kg body weight intraperitoneally daily. The testes were removed and fixed in Bouin's fluid for 24 hours. They were dehydrated in ascending strength of alcohol and the paraffin blocks were made. Four micro m thick tissue sections were obtained, stained with PAS Iron Hematoxylin method and the morphometric study was done. Students T-test was used for statistical analysis. Student's T test was used to determinate significance; P value = 0.05 was taken significant. Mean +/- SEM diameter of seminiferous tubules was 291.92+1.11706mm and 198.54 +/- 1.67282mm in groups A and B respectively after eight week of treatment. Mean diameter of seminiferous tubule of group B was decreased significantly [P<0.0001] as compared to groups A. Mean +/- SEM thickness of germinal epithelium was 96.19 +/- 1.01215 mm and 50.69 +/- 1.20064mm in groups A and B respectively after eight week of treatment. Mean thickness of germinal epithelium of seminiferous tubules of group B was decrease significantly [P<0.0001] as compare to group A. Heavy metal lead present in environment had direct toxic effects on male germinal epithelium and produced damaged on male germinal epithelium

Traumatic injuries of the permanent maxillory incisors at dental department, Pakistan institute of Medical Sciences Islamabad: a retrospective study

The study aims to ascertain the prevalence of traumatic dental injures of the maxillary permanent incisors at Dental Department, Pakistan Institute of Medical Sciences Islamabad during the years 2003-2005. Information concerning age, sex, cause, type of tooth, number of injured teeth and patterns of tooth injury were recorded retrospectively from 336 patients aged between 8-40 years, comprising 498 traumatized teeth. The dental records of all the patients presenting with dental trauma were examined for collection of data relating to age, sex, cause, number of injured teeth, type of tooth and type of tooth trauma. Type of tooth trauma was recorded according to the Andreason classification. The data was subsequently processed and analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. Of the 336 patients, 227 were males [67.6%] and 109 were females [32.4%]. The gender difference was statistically significant [P < 0.0001]. The patients had a total of 498 traumatized teeth. A large number of dental trauma occurred in patients aged between 9-11 years. Most injuries involved one tooth in 227 patients [67.6%]. However two teeth in 90 patients [26.7%], three teeth in 11 patients [3.2%] and only in 8 patients [2.3%] four teeth were involved. Fractures in enamel only occurred in 74 teeth [14.6%]. Uncomplicated crown fractures in 208 teeth [41.9%] were the most commonly encountered dental trauma. 137 teeth [27.6%] suffered complicated crown fractures, 44 teeth [8.9%] uncomplicated crown-root fractures, 19 teeth [3.8%] complicated crown-root fractures and avulsion in 16 teeth [3.2%] only. The main causes were falls in 225 patients [66.9%], collision with objects in 40 patients [11.9%], road traffic accident in31 patients [9.2%] violence in 21 patients [6.2%], and sports in 19 patients [5.6%]. The maxillary central incisor was traumatized in 384 teeth showing a high percentage of 77%. Raising public dental awareness regarding the serious outcome of traumatic dental injuries is mandatory to improve the prognosis of dental trauma and to avoid complications

Dental caries status in 6-9 years old children

The purpose of this study was to determine the dental caries status in six to nine years [6-9 years] old children. Total [n=543] patients with dental caries between 6-9 years were selected from dental OPD of Children's Hospital, PIMS, Islamabad. Names, ages, sex, addresses and caries status of each patient was recorded in separate questionnaires. Intra oral examinations were performed with mirror, probe and good light. X-rays were not taken to diagnose the caries. Among total n=543 patients, the female were 244 [45%] and male were 299 [55%]. The dmft was 7.45, 6.52, 5.74 and 5.33 for aged six, seven, eight and nine respectively. The frequency of caries was higher in age group of eight. The DMFT was 0.39 for each child. In present study the frequency of caries was found to be higher than reported by Almoudi in Saudi children and reported by Kerala in India

Comparison of radiographic and electronic working length in anterior teeth

The aim of this study was to compare the endodontic working length of anterior teeth by electronic apex locator and conventional radiographic method to determine the accuracy and reliability of latest generation electronic apex locator [Sybron Endo]. The study was carried out in the dental department of Pakistan Institute of Medical Sciences, Islamabad from April 2004 to January 2005. The use of electronic devices to determine working length has gained increasing popularity in the recent years particularly after introduction of latest generation of apex locators. An in vivo study was conducted on 30 permanent single rooted anterior teeth that were indicated for root canal treatment. First the working length was taken by electronic apex locator followed by conventional radiographic [Ingle's method]. After recording both measurements, the difference between the two results were compared to evaluate the diagnostic efficacy and ability of an electronic apex locator for accurate determination of working length. In 23 among 30 root canals, [76.6%] electronic measurement coincided with the radiographic measurements. In 4 cases [13.3%] it was short of radiographic measurements by 0.5mm. Both these results were considered acceptable however, in the remaining 3 cases the results were considered unacceptable, as in 2 cases [6.67%] it was more than radiographic measurement by 0.5mm and in 1 case electronic measurement was more than radiographic by 1.5mm. It has been concluded from the present study that the electronic apex locator is an effective device with an accuracy of more than 90%; hence it can be used as adjunct to conventional radiography but cannot replace it