Histopathological Patterns of the Testicular Biopsies and its Role in the Evaluation of Infertility Among Azoospermic Male Patients: A Hospital Based Study From Northern India

To identify and categorize various pathological patterns seen in testicular biopsies of azoospermic males along with their Johnson’s score and to evaluate the importance of the histological examination of testicular biopsies for further clinical planning. Methods: The study was conducted in the Department of Pathology of Mahatma Gandhi Medical College and Hospital, Jaipur, India. Slides prepared from testicular biopsies either unilateral or bilateral (received between January 2003 to December 2012), of 135 patients who had azoospermia on routine semen analysis were retrospectively retrieved and reviewed. Various histopathological patterns were evaluated and categorized and were graded according to the Johnson’s scoring. If more than one histological pattern was noted in the same testicular biopsy it was called as ‘Mixed pattern’ whereas if the right and left testes showed different histological pattern it was called as ‘Discordant pattern’. Results: A total of 152 testicular biopsies were collected from 135 patients (118 patients with unilateral and 17 patients with bilateral testicular biopsies). All the patients had azoospermia on routine semen analysis. The age of the patients ranged from 20 to 51 years. The most common histological pattern observed was Normal spermatogenesis (35.56%) followed by Sertoli cell only syndrome (23.70%) and Germ cell maturation arrest (20%). Hypospermatogenesis and Seminiferous tubule hyalinization was seen only in 2.96% and 2.22% of the cases respectively. Conclusion: This study has shed some light on the possible underlying etiologies of primary male infertility and emphasizes the need for bilateral testicular biopsies and on meticulous pathological examination of all seminiferous tubules in order to identify mixed and discordant patterns. The data extrapolated from our study can serve as a template for better management of primary male infertility and will optimize the advanced therapeutic modalities for the infertile couples.

Effect of Iron Deficiency Anemia on Hba1c Levels in Controlled Plasma Glucose Levels

Anaemia is a major health issue that has a wide global impact involving approximately 1/3rd of patients with anaemia. HbA1C levels are not influenced by blood glucose levels alone. Studies suggest that conditions like IDA, haemolytic anaemia, alcohol ingestion, pregnancy, blood loss, and uraemia may alter HbA1C levels independent of glycaemic status. Methods: Totally 200 patients were included in the study.. 100 patients were controlled diabetics with iron deficiency anemia and 100 were controlled diabetics without iron deficiency anemia. Comparison of levels of HbA1c was done between the two groups. Results: Correlation between mcv and hba1c is -0.76716. Which is strongly negative correlated. P – Value for the correlation test is 0.000001. Conclusion: Iron deficiency anemia has role in elevating A1C in both the groups. Iron deficiency anemia elevates HbA1c levels in diabetic individuals with controlled plasma glucose levels. The elevation is more in patients having plasma glucose levels between 100 to 126 mg/dl. Hence, before altering the treatment regimen for diabetes, iron deficiency anemia should be treated first.

Lead Associated Nephrotoxicity: A Global Concern

Amongst toxic heavy metals, lead ranks as one of the most serious environmental poisons all over the world. An occupational and environmental exposure to lead remains a serious problem in many developing and industrializing countries, as well as in some developed countries. Lead exposure can be detrimental to every organ in the human body with kidney and brain being predominantly susceptible to its deleterious effects. An association between lead poisoning and renal diseases in humans has been recognized and documented by several studies. Excessive exposure to lead may cause acute or chronic nephrotoxic effects. Studies suggest that prolonged lead exposure may be an overlooked risk factor for chronic kidney disease. Majority of lead associated renal toxicity are a result of the previous chronic exposure, ongoing chronic exposure or current high acute exposure to lead. Both glomerular and tubular effects have been reported. Glomerular effects range from high molecular weight proteinuria to a nephritic syndrome whereas tubular changes consist of an enhanced urinary excretion of enzymes. Lead poisoning and associated nephrotoxicity is an important and preventable health problem that remains to be fully addressed. However due to lack of education regarding the dangers of working with lead or lead containing products, potential health hazards of lead poisoning still exist and are rising in India. The regulatory bodies should be more vigilant and make it mandatory to evaluate and create awareness among the workers as well as general population about the lead toxicity and should insist on regular health checkups to prevent adverse health effects.

Antidepressant-like effects of Brassica juncea L. leaves in diabetic rodents.

The objective of the study was to evaluate for antidepressant like activity of a methanolic extract of B. juncea leaves (BJ 100, 200, and 400 mg/kg/day, po), and Imipramine (15 mg/kg/day, po) in alloxan monohydrate (120 mg/kg, ip) induced diabetic and nondiabetic rodents, using behavioural despair, learned helplessness, and tail suspension tests for antidepressants and locomotor activity test for quantifying the behavioural effects of treatments. In addition, effects of BJ treatments on brain levels of norepinephrine, serotonin and dopamine were also estimated. Enhanced depressive states, and motility were observed in diabetic animals. Antidepressant and motor function depressing effects of BJ were apparent in all behavioural tests in diabetic rats and mice only. Decreased contents of dopamine, norepinephrine and serotonin in brain of diabetic rats were also dose dependently compensated by repeated daily BJ treatments. However, brain dopamine level of BJ treated normal rats was higher than that in control nondiabetic. The results suggest that BJ could be a nutritional alternative for combating exaggerated depression commonly associated with diabetes.

Indicators of oxidative stress in thyroid cancer.

Ferric reducing antioxidant power (FRAP), myeloperoxidase (MPO) activity and the levels of protein thiols and carbonyls were estimated in the blood samples of thyroid cancer patients (n = 20) before and after thyroidectomy, as well as in healthy controls (n = 10) to study the extent of damage caused by tumor tissue proliferation-induced oxidative stress and to ascertain that oxidative stress levels drop, when there was no proliferation. A significant decrease (p<0.001) in the levels of serum protein thiols and FRAP as well as a significant increase (p<0.001) in the levels of protein carbonyls and MPO activity in the blood of thyroid cancer patients before surgery was observed as compared to healthy controls. All the parameters studied also showed a significant difference (p<0.001) in their respective levels in thyroid cancer patients, pre- and post-thyroidectomy. These findings present the role of oxidative stress as a pathological implication of thyroid cancer.