Intestinal spirocheteosis in a patient with celiac disease

A young girl presented to us with recurrent diarrhea along with a history of 5 kg weight loss in one year. On examination, she appeared pale, while her laboratory reports showed a low hemoglobin, mean corpuscular volume [MCV] and serum albumin. Her erythrocyte sedimentation rate [ESR] was slightly raised with her iron profile suggestive of iron deficiency anemia. Viral markers, human immunodeficiency virus [HIV] serology along with thyroid profile were all unremarkable. There was no history of tuberculosis, and purified protein derivative [PPD] skin test was also negative. Computed tomography [CT] abdomen showed thickening of the terminal ileum with multiple enlarged lymph nodes. An esophagogastroduodenoscopy [EGD] along with colonoscopy was done. Multiple biopsies were taken, which were suggestive of sprue along with intestinal spirochetosis. Her tissue transglutaminase [TTG] was negative while deamidated gliadin peptide [DGP] was positive. She was kept on gluten-free diet and started on tablet metronidazole. This case shows that intestinal spirochetosis should be kept in mind in patients belonging to lower socio-economic status, who present with chronic diarrhea symptoms

Hepatic Sarcodosis presenting as portal hypertension in a young boy

A 13-year-old boy, known case renal stone disease came with the complaints of abdominal pain along with low grade fever. On examination, hepatosplenomegaly was noted while his lab reports showed a low hemoglobulin with a raised ESR. His blood and urine cultures showed no growth. Viral markers, autoimmune profile, C and p ANCA were all negative apart from a raised serum IgG level. Ultrasound abdomen showed a hyperechoic liver with an enlarged spleen along with splenic varices and minimum ascites. Ultrasound hepatic doppler was normal. Serum AFP levels were normal while workup for Wilson's disease was negative. Fibroscan showed F4 fibosis. CT scan abdomen showed an enlarged left lobe of the liver along with an enlarged spleen. His EGD revealed varices. So liver biopsy was done that was suggestive of chronic granulomatous disease with ZN stain testing negative for TB.PPD, urine for AFB were both negative. Serum ACE levels were raised. He started ATT therapy but his condition did not improve. So, on the suspicion of hepatic sarcoidosis, he started on steroids and had a drastic improvement in his condition

use of Karnofsky Performance Status [KPS] as a predictor of 3 month post discharge mortality in cirrhotic patients

Aim: Is Karnofsky Performance Status [KPS] a predictor of 3 month post discharge mortality in cirrhotic patients?

Background: Cirrhotic patients often experience an abrupt decline in their health, which often leads to frequent hospitalization and can cause morbidity and mortality. Various models are currently used to predict mortality in cirrhotics however these have their limitations. The Karnofsky Performance Status [KPS] being one of the oldest performance status scales, is a health care provider - administered assessment that has been validated to predict mortality across the elderly and in the chronic disease populations

Methods: We used the KPS performance status scale to envisage short-term mortality in cirrhotic and HCC patients who survive to be discharged from hospital

Results: Our study showed that KPS one week post-discharge, child pugh score, hospital stay, international normalized ratio, serum albumin, total bilirubin and serum creatinine showed statistical significance on univariate analysis. On multivariate analysis, KPS was found to be statistical significant predictor of 3-month mortality

Conclusion: Hence KPS can be utilized to identify cirrhotic patients at risk of 3-month post discharge mortality

Frequency of gastro oesophageal varices in liver cirrhosis

Background: Gastroesophageal varies can present as one of the complication of liver cirrhosis

Objective: To determine the frequency of gastro oesophagealvarices in liver cirrhosis

Methodology: This was a cross sectional study, carried out at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan from 1st July to 31st December 2016. The cases of liver cirrhosis diagnosed on clinical suspicion and radiological findings of coarse echo texture of liver, dilated portal vein more than 1cm with or without ascites falling in child pugh class B and C were included. The cases were included of both gender with age range of 20-70 years. These cases then underwent upper GI endoscopy at same institute and were looked for gastro oesophageal varices. Data analysis was done by using SPSS version 20

Results: In this study, there were total 100 cases, out of which 64 [64%] were males and 36 [36%] were females. The mean age was 53+/-11 years. Gastric varices were seen in 14 [14%] of the cases. Gastric varices were significantly high in cases with child pugh class C where it was seen in 12 [17.14%] of cases with p= 0.04. This was also significantly high in cases that had duration of liver cirrhosis more than 5 years where it was seen in 13 [20.96%] of cases with p value of 0.001

Conclusion: Gastro oesophageal varices are not uncommon in cases of liver cirrhosis and it is significantly high in cases with duration of cirrhosis more than 5 years and child pugh class C

Ascitic fluid culture in cirrhotic patients with spontaneous bacterial peritonitis

Objective: to determine the frequency and compare the culture yield of bacterial isolation by conventional and blood culture BACTEC bottle techniques in cirrhotic patients with spontaneous bacterial peritonitis [SBP]

Study Design: cross-sectional comparative study

Place and Duration of Study: pathology Department, Bannu Medical College, Bannu, KPK, from January 2012 to December 2013

Methodology: paracentesis of 20 ml of ascitic fluid tapped from cirrhotic patients with SBP was carried out by a single technologist. The analysis included differential leukocyte count [DLC], while 5 ml each of the fluid was inoculated into conventional culture media and BACTEC blood culture bottle. All the data were analysed on [SPSS] version 16 to determine frequencies with percentages and mean values with standard deviation. Chi-square test was used for comparing the yield of conventional and blood culture bottle methods. P-value was considered significant if < 0.05

Results: in 105 cases of ascitic fluid analyses, 27 [25.72%] had positive ascitic fluid culture whereas 78 [74.28%] had negative ascitic fluid culture. Ascitic fluid culture was positive in 6 cases by conventional culture media and in 27 cases by BACTEC culture bottle media [p < 0.001]. Bacterial isolation was obtained by both culture methods in 6 cases [p < 0.001]

Conclusion: direct bedside inoculation of ascitic fluid by BACTEC culture bottle method has better yield as compared to conventional culture method

Chemical characterization of Siloraneby Ftir and Raman spectroscopy

Background: Silorane, introduced to the dentistry recently. It is named after the functional groups present in the material i.e. Siloxane and Oxirane. It is introduced in the market to overcome the main problems of composite resins i.e. Polymerization shrinkage. Claims are being made that the polymerization shrinkage have been overcome in the material and the material results in less than 1% polymerization shrinkage. The material claims to have properties which may fulfil the criteria of being the ideal restorative materials of all times

Objective: To confirm the presence of Siloxane and Oxirane in the chemical structure of the Silorane by Fourier Transform Infra-red [FTIR] and Raman Spectroscopy

Methods: Solvation of Silorane was done in Tetrahydrofuran [THF] using the magnetic stirrer. After the evaporation of THF, the resultant powder was then evaluated under the FTIR and Raman Spectroscopy

Results: The FTIR spectrum of Silorane shows some primary reference bands in the spectrum of Silorane and shows the absorption of primary oxirane bands. The peaks indicated the presence of Siloxane bands and CH groups. Raman spectrum of Silorane confirming the presence of _ phase of Siloxane. The peaks show the presence of O-Si-O and C = C group

Conclusion: The FTIR and Raman spectrums confirms the presence of Siloxane and Oxirane bands which results in low polymerisation shrinkage due to the cationic ring opening mechanism when compared with methacrylates which polymerises via a free radical mechanism

Bonding of acrylic resin teeth with denture base resin

The debonding of acrylic resin teeth with the denture base resin has been related to several different factors of which contamination of the bonding surfaces with wax has been suggested as the major cause. The purpose of this study was to determine the efficient method of wax removal from denture teeth using hot water at different temperatures ranges. Acrylic rods were used as tooth analogues and Raman spectroscopy was used to detect the presence of wax on the surfaces of the specimens. It was found that none of the techniques studied was able to remove all of the wax. Abraded ridge-lap surface showed least wax contamination when dewaxed at 100 degree C as compared to dewaxed at 85 degreeC and 65 degree C respectively. The spectrum for each specimen demonstrated peaks at different wavelengths and varying intensities, the spectra demonstrated traces of wax on abraded surfaces showed least wax when dewaxed at 100 degreeC as compared abraded surfaces dewaxed at 65 degree C and 85 degree C temperatures respectively

Moisturizing effect of stable cream containing Crocus sativus extracts

The present study is about to prepare stable cream of water-in-oil emulsion containing extracts of Crocus sativus against its base [without extracts] taken as control, to determine its stability on different storage conditions and effects on skin moisture contents and transepidermal water loss. The formulation contains 3% Crocus sativus [Saffron] concentrated extracts, and the base containing no extract, were formulated. Different stability tests were done on samples, which placed at 8°C, 25°C, 40° C and 40°C with 75% relative humidity, for 4 week period. These formulations [Creams] were applied on the cheeks of human volunteers for 8 week period. To evaluate any effect produced by these formulations different skin parameters were monitored every week. The significant results of this study explored the fact that water-in-oil emulsion topical cream of saffron formulated from Crocus sativus extract has absolute physical stability at different storage conditions. The increase in skin moisture contents and changes in transepidermal water loss were significant [p

Frequency and clinical presentation of oral submucous fibrosis

Oral submucous fibrosis [OSMF] is a chronic, precancerous condition of oral mucosa characterized by juxta-epithelial inflammatory reaction along with hyalinization of lamina propria. These alterations causes fibrosis and stiffness of oral mucosa leading to limited mouth opening and related problems.

To evaluate the frequency and clinical forms of Oral Submucous fibrosis

A retrospective study conducted on patients from Oral and Maxillofacial Surgery department of Dr. Ziauddin hospital Clifton, Kemari and North Nazimabad campus from 2009 till 2013. Patients with OSMF irrespective of age and gender were the inclusion criteria. The demographic information along with clinical presentation of patients was tabulated and analyzed by descriptive statistics

A total number of 70 patients with OSMF were evaluated. The most commonage group was 11-20 years in the study. There were 42 male and 28 female patients with male female ratio. The most common complaint of OSMF patients was burning sensation in oral cavity followed by limited mouth opening and dryness of mouth. The majority of patients presented with an advanced stage of disease with grade 3 interincisal distance

OSMF is becoming a disease of younger adults with a slight male predilection. The majority of patients presents with a progressive and advanced form of disease

Orally and sexually transmitted gonorrhea

Gonorrhea can be transmitted by oral sex and is known as pharyngeal gonorrhea and appears as pharyngitis. Patients with symptomatic gonorrhea infection or other STDs are commonly seen in outpatient departments. Majority of them seek treatment without having adequate understanding regarding the nature of their condition. It is important for a healthy community that the members have information regarding STDs, their spread and preventive measure. The study was conducted during the time period of six months extending from August 2013-January 2014. The data was collected from four tertiary care hospital after obtaining oral and written consent. Patients attending Urology outpatient department with a history of STD were included in the study. Overall 410 patients participated in the study with a response rate of 82%. 315[76.8%] males and 95[23.2%] female participants. 37.8% of females and 36.5 of males with total 36.8% of participants had knowledge that PID is a complication of Gonorrhea. In total 16.3% of the participants knew the correct mode of transmission of Gonorrhea with 22% females and 14.6% males with Odd ratio F/M 1.5. Regarding the best preventive measure for STD, 60.7% considers avoiding multiple sexual partners and engage in spousal relationship [53.7 and 62.8% of females and male respectively, Odds ratio F/M 0.85] is the best way followed by using condoms [20.7% of total participant with an odds F/M of 1.54]. The knowledge in patients regarding Gonorrhea is scant hence it is essential to counter educational needs of the population regarding STD in effective and timely manner

Influence of one week education program on the knowledge and approach of pharmacy students towards diabetes mellitus / Influencia del programa una semana de educación en el conocimiento y enfoque de los estudiantes de farmacia hacia la diabetes mellitus / Influência do programa uma semana de educação no conhecimento e enfoque dos estudantes de farmácia para o diabetes mellitus

The objective of this study was to assess the improvement in knowledge and attitude of Pharmacy student towards diabetes by implementing one week long education program. Study design: Study was conducted between April 25, 2011 to April 29, 2011 which engaged the 3rd professional year Pharm. D. students comprising two groups: experimental and control groups. Lectures and visual presentations on diabetic education and practice were conducted for five days. Three surveys were performed on two groups i.e. non intervened control, non- intervened experimental and intervened experimental surveys. Questionnaire was used as survey tool comprising of 46 questions under ten categories. Results: Scores in all diabetic knowledge aspect was increased after education intervention and was significantly (P<0.05) different from that of control group. Conclusion: The marked increase in knowledge about diabetes among pharmacy students illustrates the importance of educational intervention. Educational programs may markedly increase the educational skills, efficiency and confidence of pharmacy students as well as professionals.

El objetivo del estudio fue evaluar cómo mejorar el conocimiento y la actitud de los estudiantes de Farmacia hacia la diabetes, mediante la implementación de un programa de educación de una semana. Diseño: El estudio se realizó entre el 25 y el 29 de abril de 2011, entre estudiantes de 3er año de la carrera de Farmacia, conformados en dos grupos: uno experimental y otro de control. Se llevaron a cabo conferencias y presentaciones visuales en educación y práctica de la diabetes durante cinco días. Tres estudios se realizaron en dos grupos: el grupo control y experimental no intervenido y el de estudio experimental intervenido. Un cuestionario se utilizó como herramienta de estudio con 46 preguntas en diez categorías. Resultados: Las puntuaciones en el conocimiento sobre todo aspecto de la diabetes se incrementó después de la intervención educativa, lo que fue significativo (P <0,05) diferente de la de grupo de control. Conclusión: El marcado aumento en el conocimiento sobre la diabetes entre los estudiantes de farmacia ilustra la importancia de la intervención educativa. Los programas educativos pueden aumentar notablemente la capacidad educativa, la eficiencia y la confianza tanto en los estudiantes de farmacia, así como en los profesionales.

O objetivo do estudo foi avaliar como melhorar o conhecimento e a atitude dos estudantes de Farmácia para o diabetes, mediante a implementação de um programa de educação de uma semana. Projeto: O estudo se realizou entre 25 e 29 de abril de 2011, entre estudantes de 3º ano do curso de Farmácia, conformados em dois grupos: um experimental e outro de controle. Foram levadas a cabo conferências e apresentações visuais em educação e prática do diabetes durante cinco dias. Três estudos foram realizados em dois grupos: o grupo controle e experimental sem intervenção e o grupo de estudo experimental com intervenção. Um questionário foi utilizado como ferramenta de estudo com 46 perguntas em dez categorias. Resultados: As pontuações no conhecimento sobre todo aspecto do diabetes foi incrementado depois da intervenção educativa, o que foi significativamente (P <0,05) diferente das do grupo de controle. Conclusão: O marcado aumento no conhecimento sobre o diabetes entre os estudantes de farmácia ilustra a importância da intervenção educativa. Os programas educativos podem aumentar notavelmente a capacidade educativa, a eficiência e a confiança tanto nos estudantes de farmácia, bem como nos profissionais.

Effectiveness of platelete rich plasma [PRP] injections in patients with plantar fasciitis

To determine the effectiveness of PLATELETE RICH PLASMA [PRP] injection in patients with plantar fasciitis interms of improvement in at least one grade of pain on visual analogue scale at 6 weeks interval follow up. Descriptive cross sectional study. This study was conducted in Orthopedics Unit of Khyber Teaching Hospital, Peshawar from March, 2012 to Feb 2013. Patients with plantar fasciitis from the age of 20 to 50yearswho were not responding to oral medications were included in the study. There were 26 [9.38%] males and 38 [59.38%] females with mean age of 37.00 years. 45.31% patients have symptoms for 6-12 weeks where as those who had symptoms for 13-26 weeks made 48.43%of the study population. A total of 43[67.18%] patients having moderate pain before PRP only had severe pain at 6 weeks, while 25 [39.06%] had no pain, 13 [20.31%] had mild pain and 4 [6.25%] had moderate pain. Out of 21 [32.81%] patients who had severe pain before PRP, 36 [56.25%] had no pain, 18 [28.12%] had mild and 9 [14.06%] had moderate pain. Nonetheless, 3 [4.69%] had severe pain even after PRP. Over all, PRP was equally effective in patients of all ages and was more effective in men. Platelet Rich Plasma which is cheap and effective can successfully treat patients with plantar fasciitis

Child Labour in Pakistan - A tip of an iceberg

To study the basic demographic characteristics of child laborers and to ascertain their working conditions. This cross sectional study was conducted in district Rawalpindi from January to September 2008 and 700 children between 4 - 18 years were enrolled after taking informed consent from both children and their masters. Information on demography and work details was recorded on a structured performa. Total 700 children 4-18 years old with mean age of 13.5 years were enrolled. Male: Female ratio was 5.4:1. Most of the children [401] had a family size of 5-8 members. In 634 cases, 1-4 family members were earning while 05 had 10-12 earning members. Only 479 [68%] children ever attended school, mostly [291, 42%] till primary level. 258 children's families had monthly income of more than PKR 8000, 210PKR 6000-8000, 167 PKR 4000-5000 and 63 families were earning less than PKR 3000/ month. Mostly [270] worked in shops. Reason of work was low family income in 222 and poverty in 207 children. 283 children worked for 7-10 hours per day, 216 for 07 days, 115 for 4-6 hours, 45 for more than 12 hours and 39 for 1-3 hours. Maximum monthly pay was 1000- 2000 rupees in 187 and minimum 500 rupees per month in 106 children. 284 cases sustained injury while at work. Most child labourers are male with a family size of 5-8 members, never attended any school and living in a family whose monthly income is less than 8000 Pakistani Ruppee. The major reason of work was low family income and poverty

Seminal volume in the investigation of male infertility

To determine the seminal volume among infertile males and the frequency distribution of hypospermic and hyperspermic patients in infertile males. Cross-sectional observational study. Department of Reproductive Physiology/Health, Public Health Laboratories Division, National Institute of Health, Islamabad, from 2002 to 2009. Semen examinations of infertile male were carried out according to the standardized method of the World Health Organization. Seminal volume of 2-6 ml were considered normal, while volumes less than 2 ml and higher than 6 ml were considered hypospermic and hyperspermic respectively. Out of 1521 patients, 355 were hypospermic [23.34%], 1046 were normospermic [68.78%] while 120 were hyperspermic [7.88%]. In the hypospermic cases, 57 out of 355 [16.05%] had a volume of less than 1 ml. Of those 57 patients, 34 were found to be azoospermic, 12 were asthenozoospermic, one each were terato and polyzoospermic, while 6 had normal counts. Among the hyperspermic patients [n=120], 3 were azoospermic, 24 were oligozoospermic and 19 cases [15.84%] had count within the normal range, while 1 patient was polyzoospermic. Significant differences [p < 0.05] were observed among azoospermic, oligoasthenozoospermic and teratozoospermic groups when comparing hypo and hyperspermic patients. Seminal volume is an important parameter for assessment of infertility investigation and its abnormalities constitute a valuable index of problems with the male partner, even if the count and motility are well within the acceptable limits

Retrospective analysis of 68 cases of dengue fever

Dengue is a mosquito-borne febrile disease caused by any of the four serotypes of the dengue virus transmitted by the Aedes aegypti mosquito. To study the clinical manifestations and treatment practices of Dengue cases in Pakistan. Retrospective record based analysis of dengue cases was performed in 3 general hospitals of Punjab during the 2010 outbreak. Only confirmed dengue IgM [ELISA] cases were further analyzed. WHO guidelines were used to evaluate the method of diagnosis and treatment. A total of 125 suspected dengue cases were admitted in these hospitals out of which dengue IgM was positive in 68 cases. Out of 68 cases, 60[88.2%] were of dengue fever and 8[11.8%] were dengue hemorrhage fever. Tourniquet test was not performed in any case. Sixty [88.8%] cases were males. The ages of the patients ranged from 4-60 years. Sixty five patients [96%] had fever followed by myalgia in 48[70%], headache in 33[48.8%], vomiting in 30[44.8%], weakness in 48[38.4%] and abdominal pain in 25[20%] cases. Thrombocytopenia was present in 60 cases [88.8%]. In 54[43.2%] cases platelet count was below 50,000. Leucopenia was present in 45 cases [66.4%]. Analgesics were prescribed in 52 cases. Fluid replacement therapy was used in 59[87.2%] which consisted of either dextrose water or ringer's lactate or normal saline. Antibiotics were prescribed in 47 cases. WHO guidelines were not followed in the diagnosis and management of these cases. WHO guidelines for the diagnosis and management of dengue fever were not followed thus leading to unnecessary treatment and waste of resources

APACHE II scores as predictors of cardio pulmonary resuscitation outcome: evidence from a tertiary care institute in a low-income country

The aim of this study was to demonstrate that APACHE II scores can be used as a predictor of the cardio-pulmonary resuscitation [CPR] outcome in hospitalized patients. A retrospective chart review of patients admitted, from 2002 to 2007, at the Aga Khan University Hospital, Karachi, was done for this study. Information was collected on 738 patients, constituting all adults admitted in general ward, ICU, CICU and SCU during this time, and who had under-went cardiac arrest and received cardiopulmonary resuscitation during their stay at the hospital. Patient characteristics, intra-arrest variables such as event-witnessed, initial cardiac rhythm, pre arrest need for intubation and vasoactive drugs, duration of CPR and survival details were extracted from patient records. The APACHE II score was calculated for each patient and a descriptive analysis was done for demographic and clinical features. The primary outcome of successful CPR was categorized as survival >24 h after CPR versus survival <24 h after CPR. Multivariable logistic regression was used to assess the association between the explanatory variables and successful CPR. Patients with APACHE II scores less than 20 had 4.6 times higher odds of survival compared to patients with a score of >35 [AOR: 4.6, 95% CI: 2.4-9.0]. Also, shorter duration of CPR [AOR: 2.9, 95% CI: 1.9-4.4], evening shift [AOR: 2.1, 95% CI: 1.3-3.5] and Male patients [AOR: 0.6, 95% CI: [0.4-0.9] compared to females were other significant predictors of CPR outcome. APACHE II score, along with other patient characteristics, should be considered in clinical decisions related to CPR administration

Factors affecting serum ferritin level in school going children of district Bannu

To investigate the factors affecting serum ferritin level in school going healthy children in Distt Bannu, Khyber Pakhtunkhwa and to know the potential risk in children associated with hypoferritinemia, leading to microcytic hypochromic anemia in our population. This cross sectional study was carried out at Institute of Kidney Diseases [IKD] Hayatabad Medical Complex Peshawar in one year time from March 2010- March 2011. A total of 113 healthy children of both genders were selected with no history of bleeding, blood transfusion, any extensive surgery or infections. 05cc blood sample was taken from each child. Out of which, 03cc were used for ferritin estimation by using the Roche Elecsys 2010 Immunoassay Analyzer, while 02cc were used for basic hematological examination, using Sysmex k-1000. There was no significant relationship between serum ferritin of boys and girls [p>0.05].However boys had high ferritin level as compared to girls. While comparing serum ferritin in rural and urban areas it has been observed that serum ferritin was high in rural areas. Moreover serum ferritin was positively correlated with hygienic conditions [p=0.01] and dietary intake [p=0.00]. The finding of our study reveals that serum ferritin level is quite low in female population in both urban and rural areas, hence anemia and low iron status are more prevalent in female population. Environmental conditions, socioeconomic factors and diet habits are the main factors, which affect ferritin level in children

Trend of fertility potentials with increasing age in Pakistani males

The objective being to examine the magnitude and the shape of the relationships between age and semen volume, sperm concentration and sperm motility by keeping the other factors affecting fertility directly constant among patients undergoing infertility evaluation at National Institute of Health, Islamabad, Pakistan. This experimental study with non-probability sampling was conducted in Reproductive Physiology/Health, Public Health Laboratories Division, National Institute of Health, Islamabad during 2006-2009. A total 350 patients [21-50 years] were divided age wise into three groups [21-30, 31-40 and 41-50 years] to compare alteration in sperm count and motility. Semen profile was evaluated according to WHO reference value for normal semen characteristics. The result of Sperm concentration showed a non significant [p>0.05] decreasing trend with increasing age that was 0.047million/ml for every year where as sperm motility declined significantly with increasing age at p>0.05. Age-related decreases in semen qualities particularly decline in sperm motility revealed that men may become progressively less fertile as they age. However, unlike women, there appears to be no evidence of an age threshold for men

Family planning methods and gender distribution of children in a defined rural community of Peshawar

To determine frequency of different family planning methods in rural community of Peshawar and to determine gender composition of children in women practicing family planning. Data was collected from family planning program started with health education and motivation in the model community of Pakistan Medical Research Council at the village Budhni, Peshawar. The family planning method along with age of women, numbers of male and female children were recorded. Injection was a method of choice used by majority [59%] of the women. Most of the women 157 [28.3%] started family planning practice were in the age group of 26-30 years. Number of women having up to 04 children was greater [54.4%] than women [45.6%] having more than 04 children. Most [54%] of them had two male children at the time of starting of family planning. Out of 40 women with one child, 70% had one male child and 30% had a female child. Women having more male children were more likely to adopt family planning practices

Assessment of male reproductive health by conventional method of semen analysis

Data available over the past twenty years reveal that in approximately 30% of cases of infertility, pathology is found in man alone, and in another 20% both man and woman are abnormal. Therefore, the male factor is at least partly responsible in about 50% of infertile couples. The longer a couple remains sub fertile, the worse is their chance for an effective cure. This study was planned to analyse the complete semen picture of infertile men for assigning the specific cause to male infertility related to concentration, motility and morphology and to know the distribution and pattern of male infertility in the various subclasses in Pakistani population. It was a prospective descriptive analytical study conducted at Department of Reproductive Physiology/ Health, Public Health Divisions, National Institute of Health [NIH], Islamabad. One thousand five hundred twenty-one [1,521] infertile male patients, and 97 proven fathers, taken as a control. Conventional semen analysis was performed on all samples. Out of 1,521 infertile men, 13.3% were azoospermic, 23.2% oligozoospermic, 0.9% polyzoospermic, 14.5% normozoospermic, 35.2% asthenozoospermic 10.5% oligoasthenozoospermic and 2.4% teratozoospermic. Sperm concentration and active motility of proven fathers, was significantly higher [p<0.05] than the normal concentration group. Least liquefaction time was recorded in case of polyzoospermic subjects, and highest for azoospermic cases. Although, the liquefaction time of azoospermic and oligozoospermic subjects varied non-significantly [p>0.05] with the proven fathers. Normal forms were significantly higher [p<0.05] among the proven fathers and polyzoospermic cases, in comparison with the other groups. Head defects were more in teratozoospermic group, followed by oligoasthenozoospermic and oligozoospermic patients. Neck defects were more profound in oligoasthenozoospermic and oligozoospermic patients, while, tail defect showed significant increase in teratozoospermic and asthenozoospermic cases only. Head and neck defect varied significantly [p<0.05] with proven fathers in all groups, while tail defect varied significantly [p<0.05] in oligozoospermic, asthenozoospermic and teratozoospermic groups only when compared with proven fathers. Complete semen analysis which provides important information about the quality and quantity of the sperm, should be performed before reaching a final conclusion