relationship between zinc/cadmium ratio in the human semen: effect on immune response

Objective of study: To investigate the re l a t i o n s h i p between seminal levels of zinc and cadmium and spermatozoal quality, and their effects on the immune response. Study Design and Methodology: Forty-five infertile and 16 fertile males were included in this study. Investigations included semen analysis, a hypo-osmotic swelling test, antisperm antibodies by immunobeads, trace elements with atomic absorption spectroscopy and TNF- and interleukin-4 with ELISA. A high zinc/cadmium [Zn/Cd] ratio of more than 200 was associated with a normal sperm count and motility. There was an inverse relationship between the Zn/Cd ratio and impairment of spermatozoa motility. A high Zn/Cd ratio was associated with a low incidence of antisperm antibodies, especially IgA and IgM, a positive correlation with seminal IL-4 but inverse relationship with TNF-. The Zn/Cd ratio may be a better index of sperm quality than seminal zinc and cadmium, independently, through a differential reduction of the humoral immunity and enhancement of the T helper-2 cytokine Interleukin-4 as well as a down regulation of the T helper-1 cellular immune response

Human leukocyte antigens profile in women with pre-eclampsia

To evaluate the frequencies of HLA Classes 1 and 2 antigens in women with obvious pre-eclampsia when compared to normotensive controls to demonstrate evidence of genetic factor contribution in the etiology of pre-eclampsia. In this prospective case-control study all the patients were managed at the Maternity Hospital, Kuwait. About 14 ml of blood was withdrawn from 25 women with pre-eclampsia and 25 normotensive controls. HLA phenotyping was done using a Terasaki microlymphotoxicity test for both classes, land II. In HLA Class 1, A31, A34, Cw8 antigens were more common in pre-eclamptic women [p<.0.4], while A28, Bw7 and Bw8 antigens were more common in the controls [p<0.02]. In HLA Class II, DR4, DRw14, DQw14, and DQw3 were more common in the pre-eclamptic women than in the controls [p<0.05]. The Relative Risk Ratios were significant for Al, Aw24, A31, A36, B27, Bw42, Cw5, Cw7 and Cw8, as well as DR2, DR3, DR4, DRw11, DQw2 and DQ4. Pre-eclamptic women differ genetically from controls with HLA Class 1 and Class 2

Prospective randomized study comparing nifedipine versus ritodrine for the suppression of preterm labour

Nifedipine is a dihydropyridine and a calcium channel blocker during the second phase of the action potential of uterine smooth muscle cells, and ritodrine is a beta-sympathomimetic. Objective of Study: To compare the efficacy and side-effects of oral nifedipine to ritodrine in the inhibition of preterm labour. Methodology: Sixty parturients admitted to the Maternity Hospital with preterm labour who fulfilled the inclusion criteria were randomized into two equal therapy groups: [a] oral nifedipine [n = 30] and [b] intravenous ritodrine [n = 30]. During the period, the parturients were under continuous monitoring of fetal well-being, maternal uterine contractions, blood pressure, and pulse and respiratory rates. Both groups were given dexamethasone and followed up through delivery and the early neonatal period. The incidence of preterm deliveries during the study period was 6.5%. Ritodrine had a quicker onset of inhibition of uterine contractions, especially between 20 and 40 min after initiation of tocolytic therapy [p < 0.04]. Labour was delayed on the average for 40 h in the nifedipine group compared to 24 h in the ritodrine group [p < 0.05]. Eighteen patients [60%] in the nifedipine group had cessation for more than 48 h compared to 7 [30.4%] in the ritodrine group [p < 0.05]. Nifedipine inhibited uterine contractions for more than 7 days in more patients than ritodrine [13 versus 5, p < 0.05]. Ten patients in the nifedipine group went beyond 36 weeks of gestation compared to 4 in the ritodrine group [p < 0.03]. In 5 [17.9%] of the ritodrine group compared to none in the nifedipine group, treatment was abandoned because of severe side-effects of nausea [11 versus 2, p < 0.01] and palpitations [16 versus 3, p < 0.004]. There were no significant differences in the Apgar scores and neonatal morbidity. More infants in the ritodrine group [17, 73.9%] than in the nifedipine group [14, 46.1%, p < 0.05] were admitted to the neonatal unit. Nifedipine is recommended for aborting preterm contractions because it has fewer side-effects, superior efficacy and greater ease of administration than intravenous ritodrine

Cigarette smoking causes impairment of spermatozoal quality: Andrologically and biochemical evaluation

The effect of cigarette smoking on spermatozoal parameters was studied in 40 known cigarette smokers and 40 non-smokers by evaluating sperm parameters, semen and serum levels of cadmium, zinc, copper, selenium and magnesium, circulating antisperm antibodies, and FSH, LH, prolactin and testosterone. Non-smokers and light smokers had better sperm parameters than heavy smokers as indicated by the sperm count [p < 0.03], active motility [p < 0.03], asthenozoospermia [p < 0.05], and positive hypo-osmotic swelling [p < 0.05] tests. The number of smokers with higher titres of circulating antisperm antibodies was larger than that of non-smokers [>/= 1:128; p < 0.01]. Serum testosterone level was higher in non-smokers [18.4 +/- 2.1 pmol/l] than in smokers [14.3 +/- 2.5 pmol/l; p < 0.05]. Cadmium levels were higher in the semen and serum of smokers [p < 0.05] when compared to non-smokers [p = 0.05]. Cigarette smoking impairs fertility through the putative effect of cadmium in causing testicular endothelial injury and production of antisperm antibodies

Simplified hypo-osmotic swelling test as a test of fertilizing capacity obstetric outcome

The hypo-osmotic swelling test is useful in the evaluation of the sperm membrane's integrity, The association between a standard hypo-osmotic swelling test [HOS], and a simplified water HOS, and the pregnancy outcome was investigated, in sixty men and their wives who had patent tubes and evidence of ovulation with at least 12 months infertility. Data analysis showed that the men had a mean age of 34.8 +/- 6.1 [range 21-65] years, mean fertility duration of 7.4 +/- 3.9 [range 2 - 21] years; 86,7% had primary infertility. There was a strong correlation between standard HOS and water HOS tests [r = .71, P<.01] and between the total spermatozoal motility and the HOS tests [r = 0.63 and r = 0,59, P<.01]. Water HOS with > 60% resulted in a 38.5% pregnancy rate, compared to an 8.3% pregnancy rate in those with water HOS 50-59% [P <.001] and 2.9% for HOS below 50%. Water HOS has a strong correlation with a standard HOS and can therefore be used in place of the latter

Trends and determinants of cesarean section in Kuwait maternity hospital

The rise in cesarean section [CS] rates seen throughout the world has been a source of concern in many countries. The aim of this study was to investigate both the main determinants of CSs and the trend in CS rates at the Kuwait Maternity Hospital from 1973 to 1989. The records of all deliveries at the Kuwait Maternity Hospital during the 17-year study period were scrutinized to determine the main indications for the CS and to calculate the annual rate of CS. For comparison, the study was divided into two periods, 1973-1980 and 1981-1989. The results showed that the CS rate increased from 3.9% in 1973 to 12.6% in 1989 [p < 0.0001]. There was a rapid increase in the CS rate from 1973 to 1980 and a gradual but consistent increase from 1981 to 1989. The main indications for performing a CS were failure to progress in labor, previous CS, fetal distress, abnormal presentation and medical disorders in pregnancy. All individual indication rates increased during 1981-1989 when compared to 1973-1980. During the second period, previous CS became the dominant indication. The CS rate of 12.6% in 1989 was comparable to the low rates recorded in Europe. It could, however, be lowered in response to the prevailing pronatalistic attitude of the community. Involvement of senior staff in the decision to perform a CS is advocated