ABSTRACT
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Subject(s)
Female , Humans , Male , Antioxidants , Classification , Clinical Protocols , Diagnosis , DNA , Embryonic Structures , Fertility , Health Expenditures , Infertility , Infertility, Male , Membranes , Ovum , Oxidants , Oxidation-Reduction , Oxidative Stress , Reactive Oxygen Species , Reducing Agents , Reproductive Health , Semen , Spermatozoa , Subject HeadingsABSTRACT
During the 6 years from 2001 to 2006, a total of 18,443 M. tuberculosis isolates were processed for drug sensitivity testing. Of those, 9614 [52.12%] were found to be multidrug resistant. A total of 86 [0.89%] cases met the criteria of XDR among the MDR-TB cases. Year-wise detection of these XDR cases is given in Table I. A consistent decline was observed in the incidence of reported cases of XDR over the years right from the year 2001. These 86 cases were reported from 7 states with the largest number from Delhi [49] followed by neighbouring Rajasthan [10], Haryana [9], Uttar Pradesh [8], Uttaranchal [5], Punjab [4] and Madhya Pradesh [1]. Of those 86 cases, only 5 patients were females and rest were males. A total of 53 out of 86 [61.6%] of the isolated resistant strains were resistant to more than 4 classes of drugs indicating severity of resistance