Does cigarette smoking affect seminal fluid parameters? a comparative study

To study the effect of cigarette smoking on seminal fluid parameters, namely; volume, sperm concentration, and motility, as well as morphology, leukocyte infiltration, among males complaining of infertility Between August 2010 and July 2011, seminal fluid analysis was done for 1438 males who are partners of couples who visited the infertility clinic at Prince Rashid Ben Al Hassan Hospital [PRH] for infertility. The men who fit the inclusion criteria [n=960] were classified into two groups: group a [non-smokers; n=564] and group B [smokers; n=396], which represents 41.25% of the study group. Seminal fluid was collected using masturbation after 3-5 days of abstinence then analyzed for volume, sperm count, sperm concentration, motility and morphology. In order to analyze whether the number of cigarettes smoked per day has an effect on the spermatogram; the smoking men were divided into two subgroups: the heavy smokers [n=266] and non-heavy smokers [n=130]. A total of 960 adult males were enrolled. Their age ranged between 21 and 76 years, 564 were non-smokers with mean age of 36. 45 +/- 6.27 [Mean +/- SD]. Three-hundred-and-ninety-six were smokers with a mean age of 34.3 5 +/- 4.25 [Mean +/- SD]. There was a significant effect of smoking on the motility of sperms and the ratios of abnormality [p<0.005]. Concentration appeared not to be affected by smoking. Furthermore, the group of heavy smokers were found to have lower sperm concentrations and a higher percentage of abnormal sperms compared to the non-heavy smokers. Cigarette smoking has a deleterious effect on some of the seminal fluid parameters [motility, morphology and leukocyte count] which in turn may result in male subfertility

Discontinuation rates among women using either the combined oral contraceptive pills or an intrauterine contraceptive device for contraception: a comparative study

To study the contraceptive practice of women using combined oral contraceptive pills and intrauterine contraceptive devices in 4 Jordanian military hospitals; [Prince Hashem Bin Al Hussein, Prince Ali Bin Al Hussein, Princess Haya Bent Al Hussein, and Queen Alia Hospitals] and to study the reasons for discontinuation of these methods among women less than 44 years of age. A retrospective analysis of the family planning medical files of 5800 clients who were current or past user of the contraceptive pills or intrauterine devices for contraception during the period between January 2007 and December 2009 was done. Fifty-eight percent [33671 5800] were current or past contraceptive pills users and 41% [2433/5800] were current or past intrauterine device users. Women included in the study were those who had discontinued using the pills or the devices for more than 6 months [n = 3200], which in turn were divided into two groups: Group A, oral contraceptive pills users [n=2050] and Group B, intrauterine devices users [n = 1.150]. We then analyzed according to age, parity, obstetric history, medical history, duration of contraception and reasons for discontinuation of these methods; the data were compared between the two groups.The use of contraceptive methods varies across age, but combined oral contraceptive pills was found to be the most commonly used method among the study population. Only 29% of group A discontinued the pills because of their desire to conceive compared to 23.6% of group B. Fifty-two percent of group A stopped the pills because of undesired side effects, compared to 65% among group B. Four-point-four percent of group A stopped the method due to medical indication compared to 3.2% in group B. Fourteen-point-six percent of group A stopped the pills for personal reasons or lack of availability of the drugs and 8.2% of group B had the device removed because it reached the expired date [being in uterus for 10 years]. However, this is not considered a reason for discontinuation. The main side effects of combined oral contraceptives were breast discomfort, mood changes, weight gain, headache, nausea and vomiting, whereas the commonest side effects related to intrauterine contraceptive device were menstrual bleeding disorders, recurrent vaginal infection, and pelvic pain. In spite of the safety and high efficacy of combined oral contraceptive pills and intrauterine devices as contraceptive methods more than half discontinued their use because of undesired side effects. This may be improved by careful patient selection and appropriate counseling

Heterotopic pregnancy: a case report

Heterotopic pregnancy is a catastrophic form of ectopic pregnancy and its incidence is still low but it is increasing, mainly secondary to the increase in assisted reproductive technology procedures. The definition of heterotopic pregnancy is the simultaneous development of an intrauterine pregnancy and an extrauterine one. We report a case of 33-year-old woman with intrauterine viable fetus and right tubal heterotopic pregnancy

Maternal satisfaction and caesarean section done under regional anesthesia

To determine the maternal satisfaction and subjective sensation of patients during caesarean section under regional anesthesia and whether regional anesthesia would be preferred for a future caesarean section.Study design: This is a prospective study of 164 patients, who were previously underwent caesarean section under general anesthesia, undergoing caesarean under regional anesthesia in Prince Rashid Hospital between 1st of August 2003 and 30th of July 2004.Patients were asked questions 2 hours after the operation regarding to their experience during the operation.Hundred and twenty three patients [75%] choose the phrase pulling and pushing, 115 patients [70%] describe their feeling as pleasant, 16 [9.1%], patients describe it is umpleasant, 33 [20%] patients were saying it was neither pleasant nor non pleasant. Hundred and forty one patients [86%] said that they would preferred a future caesarean section to be done under regional anesthesia, 13 patients [8%] were unsure about their decision and 10 patients [6%] said they would prefer a general anesthesia for a next casesaren section.Conclusion:Most of our patients group find regrional anesthesia pleasant and prefer regional anesthesia over general anesthesia