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

Rapid immunochromatography-based detection of mixed-species malaria infection in Pakistan.

We report the identification of mixed Plasmodium infections in four recent patients with malaria clinically refractory to empiric chloroquine therapy using the rapid antigen detection kit, NOW ICT Malaria Pf/Pv. A rapid in vitro immunodiagnostic test, the NOW ICT Malaria Pf/Pv test kit was used for the detection of circulating Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) antigens in whole blood. Peripheral blood microscopy confirmed mixed-species infection in all the cases. Thick and thin peripheral blood films were made and stained with Giemsa stain and examined by both hospital laboratory staff and an experienced parasitologist who was blinded to the results of the rapid malarial antigen tests. Four recent patients (all male; mean age, 24 years) with mixed malarial infection were identified. All the subjects were males working for an oil company in a coastal area of Pakistan, and all had been diagnosed presumptively with malaria based on clinical grounds (without microbiologic confirmation), and were treated empirically with chloroquine without clinical response. Semiquantitative malaria counts via microscopy were as follows: P. vivax, scanty (2 patients) and moderate (2 patients); for P. falciparum--scanty (1 patient), moderate (2 patients), and heavy (1 patient). The present case series, although limited by the small number of patients with proven mixed P. falciparum-P. vivax infection, highlights the usefulness of the rapid antigen test in a highly malarious region of Pakistan where chloroquine resistance is prevalent. Although there was full concordance between the results of blood smear microscopy and rapid antigen testing, these techniques are potentially most useful when there is a discrepancy with microscopy findings. Accurate and rapid diagnosis of parasites, particularly in cases of mixed P. falciparum and P. vivax infection, is of immense importance for individual patient management and in reducing the burden of disease, especially in regions of chloroquine resistance.

Tropical pulmonary eosinophilia and filariasis in Pakistan.

Filariasis is a major health problem in South Asia, particularly India, Sri Lanka and Bangladesh. Pakistan was presumed to be not affected. We report for the first time confirmed cases of tropical pulmonary eosinophilia (TPE) in indigenous patients as a result of infection with Wuchereria bancrofti. Following clinical examination, total leukocyte and eosinophil counts were recorded. Parasitological examinations included blood for microfilariae and stool and urine for eggs of intestinal parasites. Total immunoglobulin (Ig) E and specific antifilarial IgG were measured. Suspected cases of TPE were treated with diethylcarbamazine, 6 mg/kg for four weeks and were followed up to 2 and 4 weeks after treatment. Four persons fulfilled the criteria for TPE. Their response to treatment was marked with clinical improvement, reduction in eosinophil count and reduced titers of specific antifilarial antibodies. Two persons had W. bancrofti antigen in their sera confirmed by filariasis antigen detection test. Tropical pulmonary eosinophilia due to Wuchereria. bancrofti, although rare, is present in Pakistan.