ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
Background: Chronic suppurative otitis media (CSOM) is a commonly encountered infection of the middle ear. It cancause extra cranial and intracranial complications and involves considerable morbidity. Although it is a global disease, its incidence has remained relatively higher in resource-constrained countries. Due to its recurrent nature and the development of resistant pathogenic organisms, control of infection poses a greatest therapeutic challenge. Knowledge of the local microbial flora in CSOM is essential for initiating empirical therapy. The objective of our study was to examine the current bacteriological profile and antibiotic sensitivity pattern to locally available antibiotics in CSOM. Methods: A total of 157 patients clinically diagnosed of CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and were processed as per standard microbiological techniques. Antibiotic sensitivity to ten locally available antibiotics was analyzed. Antibiotic susceptibility testing for bacterial isolates was conducted using Kirby-Bauer disc diffusion method. Results: Out of total 157 swabs bacterial growth was seen in 144 (91.72%) with Pseudomonas aeruginosa (28.5%) and Staphylococcus aureus (22.9%) being the most common bacterial isolates. Among the antibiotics tested amikacin (88.3%), ciprofloxacin (78.9%) and cotrimoxazole (78.2%) were found to be most active against all the isolates, whereas maximum resistance was seen for ampicillin (45.8%). Poor hygiene 79 (50.3%) and pond/river bath 51 (32.5%) were the two most common predisposing factors associated with CSOM. Conclusion: In the era of continuously increasing drug resistance among bacteria, periodic monitoring of the bacterial isolates causing CSOM and their antibiogram with clinical correlation is very important. Local antimicrobial susceptibility data should be utilized for formulating antibiotic policy for every institution. Our results will surely help in the modification of hospital’s current antibiotic policy and also will optimize the therapy to patients.
ABSTRACT
Trichosporon asahii (formerly known as Trichosporon beigelii) is an emerging, life-threatening opportunistic pathogen and has been found to be invariably associated with disseminated or deep-seated trichosporonosis, more so among the patients with granulocytopenia or hematological malignancies. We here report a successfully treated case of disseminated trichosporonosis in a known diabetic, 14-year-old girl, admitted to our hospital with chief complaints of fever, chills, and burning micturition since 3 weeks. Disseminated trichosporonosis is usually an insidious disease with poor prognosis. Early diagnosis is crucial for successful treatment. High index of clinical suspicion and extensive microbiological investigations can clinch the diagnosis.