Endocrine disruption and infertility: Circulatory hormone and bisphenol A concentrations in infertile Saudi women

Aim: Human infertility is a public problem and a cause of social and psychological complications affecting more than 50 million couples globally. Bisphenol A (BPA) is a ubiquitous environmental endocrine disrupting chemical and has been associated with infertility problems in women.The aim of the present study was to analyze concentrations of bisphenol A and circulating hormones in infertile Saudi women for evaluating the association of BPA with infertility.Methodology: The present study was done on 43 infertile women for evaluating possible association of systemic BPA concentrations with infertility in Saudi Arabia. The clinical indications were irregular menses, hyper-androgenism, multiple small ovarian cysts, polycystic ovarian syndrome and unexplained infertility. Blood samples from infertile women and a control group of 18 healthy fertile women were analyzed and compared for concentrations of BPA and circulatory hormones. Results: The results showed that BPA concentrations were not significantly different between infertile women and controls. BPA concentrations were also not correlated with systemic hormone concentrations in infertile women. Interpretation: Serum BPA levels had no association with hormone imbalance in this cohort of infertile Saudi women. However, considering the previous studies that have shown a relationship of BPA with female infertility, an argument can be made that there might be lower exposure of Saudi population to BPA in comparison to BPA analogues such as BPS (according to recent reports). Therefore, it is suggested to conduct more infertility studies that include detection of BPA and its analogues in infertile Saudi women

Efficacy of the 6-month thrice-weekly regimen in the treatment of new sputum smear-positive pulmonary tuberculosis under clinical trial conditions.

Background. Under the Revised National Tuberculosis Control Programme of India, patients with new smear-positive pulmonary tuberculosis are treated with a thrice-weekly regimen of antitubercular drugs (2H3R3Z3E3/4H3R3 [H isoniazid, R rifampicin, Z pyrazinamide and E ethambutol]) for 6 months. We conducted a retrospective analysis of the efficacy and tolerability of this regimen under clinical trial conditions in HIV-negative patients with newly diagnosed smear-positive pulmonary tuberculosis. Methods. We retrospectively analysed the data on patients assigned to the control regimen (2H3R3Z3E3/4H3R3) in two clinical trials during 2001–06 at the National Institute for Research in Tuberculosis, Chennai, India. Results. Of the 268 patients treated with this regimen, data for efficacy analysis were available for 249. At the end of treatment, of 249 patients, 238 (96%) had a favourable status. Treatment failure occurred in the remaining 11: 7 in whom the organisms were initially drug-susceptible and 4 with initial drug resistance. Of the 238 patients who had a favourable status at the end of treatment, 14 (6%) had recurrence of tuberculosis during the following 24 months. In the intention-to-treat analysis, 245 (94%) of 262 patients had a favourable status at the end of treatment. Of the 28 patients with initial drug resistance, 24 (86%) had a favourable outcome. Only 4 of these 24 patients were found to have recurrence of tuberculosis in 2 years of follow-up. Among the 221 patients initially infected with drug-susceptible organisms, drug resistance did not develop in any of the 7 patients in whom the treatment failed or the 10 who had recurrence of tuberculosis. Further, 5 of the 7 patients in whom the treatment failed continued to excrete drug-susceptible bacilli at 6 months. Adverse drug reactions were observed in 38 (14%) of the 262 patients. Only 3 (1.1%) needed a modification in the treatment. Conclusion. This thrice-weekly 6-month regimen of antitubercular drugs, when administered under full supervision, is associated with a high rate of favourable treatment outcomes in HIV-negative patients with newly diagnosed sputum smearpositive pulmonary tuberculosis. There are few adverse drug reactions in these patients.

Sepsis due to linezolid resistant Staphylococcus cohnii and Staphylococcus kloosii: First reports of linezolid resistance in coagulase negative staphylococci from India.

Linezolid, a viable alternative to vancomycin against methicillin resistant staphylococcal isolates, has been in use for a decade around the globe. However, resistance against staphylococci remains extremely rare and unreported from most of the Asian countries. Herein, we report two cases of linezolid resistant, coagulase negative staphylococcal sepsis for the first time from India. The first case was an 18-year-old burn patient, who, after a major graft surgery, landed in sepsis, and linezolid resistant Staphylococcus cohnii with an minimum inhibitory concentration (MIC) of >256 μg/ml by both broth microdilution and Etest, was isolated from multiple blood cultures. The second patient was a 60-year-old male with an intracranial bleed and sepsis, from whose blood cultures, linezolid resistant Staphylococcus kloosii was repeatedly isolated. Linezolid MIC was >32 μg/ml by broth microdilution and >16 μg/ml by Etest.

Homicidal aluminium phosphide poisoning.

Dead body of a female was brought for postmortem examination at the mortuary of New Civil Hospital, Surat. History revealed that her husband had given three tablets to her on the pretext that these tablets would help in the birth of a male child. She became ill soon after consuming the tablets and died within 12 hours of ingestion while under treatment. Autopsy revealed death from aluminium phosphide poisoning. This unusual case is presented here.

Validity of self-reporting questionnaire and Rahim Anxiety Depression Scale

The Self-Reporting Questionnaire and Rahim Anxiety-Depression Scale are instruments used for screening minor psychiatric morbidity. The aim of this study is to test and compare their validity and reliability in a sample of Saudi adult diabetic patients. A random sample of 226 adult diabetics and an equal number of matched normal subjects were interviewed using a structured questionnaire including socio-demographic and clinical characteristics, as well as the Self-Reporting Questionnaire and Rahim Anxiety-Depression Scale. A sub-sample of 49 patients were further clinically assessed according to DSM-IV diagnostic criteria. Indices of inter-rater and test-retest reliability were in the range of 84% to 88%. Validity measures, reached by comparing the results of the screening tests with the blind clinical judgement of qualified psychiatrists, showed ranges of sensitivity between 70% and 94%, specificity between 72% and 84%, overall accuracy rate between 71% and 84%, and odds ratio between 6.3 to 48. Factor Analysis extracted 5 factors: one of predominantly depressive symptoms, 2 of somatic complaints, one of psychic anxiety, and one of neurasthenic manifestations. Compared to Self-Reporting Questionnaire, Rahim Anxiety-Depression Scale gave consistently higher values in all tested indices of validity. The 3 instruments seem reliable and valid in screening psychiatric morbidity in diabetic patients. Rahim Anxiety-Depression Scale, which incorporates all the items of Self-Reporting Questionnaire and Somatization Sub-scale, was found superior to Self-Reporting Questionnaire alone, and it allowed for probing the severity, as well as the frequency, of reported symptoms