study of sperm morphology in a Pakistani population

The aim of this study was to determine the sperm morphology of proven fertile males and to compare the same with that of infertile males. This study was carried out at International Medical College Rawalpindi and its attached Railway hospital and Islamabad Clinic Serving Infertile Couples Islamabad, from June 2005 to July 2006. 50 healthy fertile males were selected and their semen morphology was determined according to Tygerberg's strict criteria, while another 50 infertile males were recruited as controls Proven fertile group showed significantly higher morphologically normal forms of sperms [3.04 +/- 1.63] than the infertile group. Sperm morphology assessed by strict criteria is of value in the in-vivo situation to identify a group with greater chance of having an infertility problem and strict criteria sperm morphology analysis should be used to minimize variations in intra and inter-individual and inter-laboratory sperm morphology assessment

Physiological basis and clinical utility of erythrocyte sedimentation rate

The erythrocyte sedimentation rate [ESR] determination is a commonly performed laboratory test with a time-honored role. However, the usefulness of this test has decreased as new methods of evaluating disease have been developed. The test remains helpful in the specific diagnosis of a few conditions, including temporal arteritis, polymyalgia rheumatica and, possibly, rheumatoid arthritis. It is useful in monitoring these conditions and may predict relapse in patients with Hodgkin's disease. Use of the ESR as a screening test to identify patients who have serious disease is not supported by the literature. Some studies suggest that the test may be useful as a "sickness index" in the elderly or as a screening tool for a few specific infections in certain settings. An extreme elevation of the ESR is strongly associated with serious underlying disease, most often infection, collagen vascular disease or metastatic malignancy. When an increased rate is encountered with no obvious clinical explanation, the physician should repeat the test after an appropriate interval rather than pursue an exhaustive search for occult disease

Hereditary persistence of fetal hemoglobin and thalassemia trait incidence in our population [a study of 300 adult subjects]

A prospective study of 300 adult subjects of either sex was conducted to evaluate the existence of hereditary persistence of foetal haemoglobin [HPFH] in our population. The majority of the subjects [98%] were found to have H[b]F values less than 2% with a mean SD of 0.73 +/- 0.54% and showed H[b]A2 levels as 2.67 +/- 0.66%. Only six subjects [2%] had moderate elevation of H[b]F [2% and above] and they all showed associated increase of H[b]A2 levels above the normal. Increased H[b]A2 levels in conjuction with elevation of H[b]F indicated the presence of heterozygous beta thalassaemia trait among this group. The incidence of thalassaemia trait in the 300 subjects studied was found to be 1.6%. The distribution of H[b]F in the erythrocytes was found to be heterocellular. Moderate rise of H[b]F in the individuals with uneven distribution, ruled out the existence of pancellular form of HPFH while the associated elevation of H[b]A2 was not consistent with heterocellular form of HPFH. Thus the existence of gene for HPFH among these subjects could not be proved