Seminal bacterial contaminations: probable factor in unexplained recurrent pregnancy loss

It is estimated that about 50% of causes of recurrent pregnancy loss [RPL] cases remain unknown. Sperm factors are suggested to have probable role in cases with RPL. The goal was to determine the possible relationship between semen bacterial contaminations with unexplained RPL. Also, the correlation between number of bacterial colony and sperm chromatin condensation was examined This study consisted of 30 fertile men [group A] and 30 infertile [group B] men with unknown RPL. Semen collection and analysis were done according to WHO manuals. Sperm count and motility were evaluated by Makler chamber. Eosin-Nigrosin and Papanicolaou staining methods were applied for viability and morphology assessment, respectively. The semen samples from both groups were cultured for aerobic bacteria. Aniline blue [AB] and toluidine blue [TB] staining methods were applied for evaluating sperm chromatin condensation. The numbers of colonies were significantly higher in group B when compared to group A. Also, S. aureus and E. coli contaminations showed significant differences between two groups. Both AB+ and TB+ sperm cells showed significant increase in group B compared to group A. There was a significant negative correlation between colony number and progressive motility [p=0.01], and sperm viability [p=0.007]. In addition, positive correlations were found between colony number and AB+ [p=0.001] and TB+ [p=0.004] as well. Bacterial contaminations in semen of men from RPL couples had significantly higher levels when compared to fertile controls. Presence of microorganisms in semen may be correlated with irregular sperm parameters and quality

Erythromycin decreases the time and improves the quality of EGD in patients with acute upper GI bleeding

To evaluate the efficacy of erythromycin to decrease the time and improves the quality of EGD in patients with acute upper GI bleeding. The diagnostic and therapeutic value of esophagogastroduodenoscopy [EGD] in patients with upper GI bleeding is often limited by the presence of residual blood or clots. Infused erythromycin [3 mg/kg] before EGD, a potent gastro kinetic drug, might improve the quality of EGD in patients with upper GI bleeding and decrease the time of EGD and second- look EGD. In a prospective, randomized, double-blind controlled trial, 40 patients with acute upper gastrointestinal bleeding in Taleghani hospital, Tehran, Iran were studied. The patients were randomized into 2 groups: 1] nasogastric tube placement receiving placebo, and 2] intravenous erythromycin infusion [3mg/kg at 30 min] combined with nasogastric tube placement. The primary end point was endoscopic yield, as assessed by objective and subjective scoring systems and endoscopic duration. Secondary end points were the need for a second look, blood units transfused, and length of hospital stay and mortality. A clear stomach was found more often in the erythromycin group [100% vs. 25%; P< 0.001]. Erythromycin shortened the endoscopic duration [14 vs. 32 minutes in the placebo group; P< 0.001] and reduced the need for second-look endoscopy [1 vs. 3; P< 0.001], admission duration [2 vs 5; P< 0.001] and reduced the blood units transfused [2 vs 4; P< 0.001]. In patients with acute upper GI bleeding, infusion of erythromycin before endoscopy significantly decreases the time and improves the quality of EGD