Role of nitric oxide in male infertility.

It has been proposed that oxidative stress plays an important role in male infertility. Many environmental, physiological and genetic factors have been implicated in poor sperm function and infertility. Although there are some definite causes for male infertility still the term “Idiopathic Infertility” remains. Various studies are going on effect of oxidative stress on fertility potential of male which can be one of the causes of idiopathic infertility. Reactive oxygen species (ROS) are highly reactive oxidizing agent belonging to class of free radicals. Excessive generation of ROS in semen by leukocytes as well as by abnormal spermatozoa could be a cause of infertility because it leads to injury to spermatozoa.Nitric oxide (NO) is one of the reactive oxygen species that has been implicated in variety of physiologic cell signaling mechanisms in many tissues and is recognized as a molecule that importantly regulates the biology and physiology of reproductive function.The clinical significance of seminal oxidative stress is suggested by several independent studies indicating a link between peroxidative damage to human spermatozoa and the incidence of male infertility.

Serum enzymes changes after death & its correlation with time since death.

Estimation of time since death is one of the primary objectives of an autopsy. Forensic Scientists and researchers have been persevering hard to find out methods of accurate determination of postmortem interval since long. However, the concept of “Postmortem Clocking” so far seems to be a distant dream only. The favorite biological fluids, to study postmortem biochemical changes, have been those which withstand putrefactive changes for longer duration, like vitreous humor, cerebrospinal fluid, pericardial fluid etc. In blood, markers like electrolytes, urea, creatinine, glucose etc have been more commonly studied. Enthusiastic studies have been undertaken by various researchers to find out reasonably reliable methods of estimating postmortem interval by studying serial quantitative changes in serum levels of various enzymes and to extrapolate the data obtained therefore in terms of duration of death. However, the accuracy of such an opinion remains big area of concern even today, as the range of duration is mostly too wide to be practically useful.

Retinitis pigmentosa and congenital toxoplasmosis: a rare coexistence.

We describe a previously unreported co-existence of retinitis pigmentosa and congenital toxoplasmosis. An eight year old male presented to our center with complaints of decreased night vision. Fundus evaluations in both the eyes demonstrated features typical of retinitis pigmentosa. There were well-defined punched out healed chorio-retinal scars suggestive of congenital toxoplasmosis. On the basis of history, clinical findings and reduction of a and b wave amplitudes on scotopic and photopic electroretinograph, a diagnosis of retinitis pigmentosa with congenital toxoplasmosis was made. Retinitis pigmentosa may co-exist with congenital toxoplasmosis that may affect the patient's overall ocular morbidity and visual acuity.

Immunotoxicity induced by subacute acephate exposure in white leghorn cockerels.

Acephate (Ace) is an organophosphate foliar spray insecticide of moderate persistence with residual systemic activity of about 10–15 days. This study was designed to evaluate the immunotoxic effect of oral subacute acephate exposure in 125-day old WLH Cockerel chicks for 28 days. The experimental birds were randomly divided into five groups (C1, C2, T1, T2 and T3), each comprising 25 birds. The birds of group C1 were given no treatment and served as control. Group C2 was administered groundnut oil (1ml/kg) and served as control (vehicle). Group T1 was given ALD50/40 (21.3 mg/kg), and Group T2 was put on ALD50/30 (28.4 mg/kg), while group T3 received ALD50/20 (42.6 mg/kg) of acephate suspended in groundnut oil. Experimental birds of all groups were vaccinated with New Castle disease vaccine at day 7. Blood was collected at two-week intervals for evaluation of humoral immune response. Parameters such as TLC, TP, antibody titre against ND vaccine, DNCB dye test, and histopathology of immune organs were studied to evaluate immunotoxicity. The results were statistically compared (p<0.05) with the control. Acephate produced decreased humoral immune response in terms of New Castle disease vaccine antibody titre, total protein, serum globulin, and serum albumin. Cell mediated immune response was checked with 1-chloro 2, 4 dinitrobenzene dye dermal sensitization test, and it did not reveal any significant differences. Lymphoid organs such as thymus, spleen, bursa, and liver were weighed during necropsy for calculation of organ weight: body weight ratio. After 28 days of acephate exposure, organ:body weight ratios of immune organs were significantly reduced except liver:body weight ratio on 14 days of exposure, which was increased in all treatment groups as compared to control groups. Histopathologically, bursa and spleen showed mild depletion of lymphocytes. To further identify the specific type of cell death as apoptotic or necrotic, DNA ladder assay was performed. DNA fragmentation assay detected ladder pattern (180bp) in DNA from hepatocytes and splenocytes of acephate-treated birds. It is concluded that acephate is immunotoxic, and exerts its immunotoxicity through induction of apoptosis and alteration of immunological parameters.

Reconstruction of body injuries leads to unraveling mystery behind unidentified mutilated skeletonised human remains.

Medico legists are frequently requisitioned by investigating agencies to examine and opine regarding identity, cause, manner & time since death of unidentified mutilated decomposed/ skeletonised human remains. Such an opinion in some of these cases can be very intriguing or even impossible to make. However, availability and examination of relevant facts/ information/ documents with regards to circumstantial evidences and their corroboration with autopsy findings including reconstruction of body injuries and examination of articles pertinent to the case can do wonders in this regard. The case relates to unidentified mutilated human remains in advanced stage of decomposition, partial adipocere formation, near skeletonisation & partial mutilation, recovered from a ground well not in use for drinking water purpose, tied to a heavy stone slab. The pelvis and left Femur bones showed sharp cut injuries in unique and patterned fashion. The paper discusses important issues of reconstructive Forensic Medicine in the light of the given case.

Ocular and cardiovascular autonomic function in diabetic patients with varying severity of retinopathy.

The study was conducted to assess the ocular and cardiovascular autonomic function in diabetic patients with varying severity of diabetic retinopathy. Ocular and cardiovascular autonomic function tests were performed in 30 patients with type 2 Diabetes Mellitus (10 in each group of proliferative retinopathy, non-proliferative retinopathy and no retinopathy) of more than 5 years duration and 10 normal controls. Ocular autonomic function tests were done by measuring pupil cycle time and denervation hypersensitivity with 0.125% pilocarpine and 0.5% phenylephrine. Cardiovascular autonomic function was measured by a battery of standard tests. Denervation hypersensitivity to 0.125% pilocarpine and to 0.5% phenylephrine and pupil cycle time showed statistically significant differences (P value < 0.001) between controls and patients with proliferative retinopathy (PDR) and also between no retinopathy and PDR (P < 0.001). Systemic autonomic function tests namely expiration--inspiration ratio, difference in heart rate, 30th beat and 15th beat ratio in head up tilt and difference in diastolic blood pressure in head up tilt test also showed significant difference (P < 0.01) between controls and all 3 groups of diabetics. There was statistically significant difference found in para-sympathetic ocular autonomic dysfunction between NPDR and controls. Ocular and systemic autonomic dysfunctions are related to the severity of diabetic retinopathy.

Suspected snake bite turning out to be death due to choking round worn infestation): A case report.

A six years old female child was brought to the casualty department of Dr. B.R. Ambedkar Hospital and associated Pt. J.N.M. Medical College, Raipur (C.G.) with the history of snake bite. On autopsy signs of asphyxia and one large round worm was found in lower respiratory tract. No animal bite mark could be found as alleged by relatives and police. Later on it was revealed by relatives of the deceased that the girl had passed four round worms in stool three year back. For which she was given some medications. The small intestine was studded with multiple round worms most of which were live. The intestine contained very little amount of digested food material. The social, ethical and medico legal issues involved in sudden suspicious deaths in the state of Chhattisgarh and too frequent histroy of snake bite in most of them is discussed in the paper.

Hidden weapon (blade of a knife) in a case of homicidal stab wound-a case report.

A case of Homicidal stab wound to the chest was autopsied at Department of Forensic Medicine & Toxicology, Pt. J.N.M. Medical College, Raipur (C.G.). The blade of a knife (on exploration of the track of the stab wound), was found in situ within the chest cavity, with tip of knife being thrust in one of the thoracic vertebral body. The handle of the weapon was missing. The metallic blade was not visible from outside. Right lung and heart have sustained injuries along the track of the wound. The tip of the weapon has cut and was present in situ in 0.5 cms depth of the vertebral body. Beside stab wound only two contusions on back and one abrasion on forehead were present on the body.

Osseous choristoma of the choroid.

Osseous choristoma of the choroid, also called choroidal osteoma, is a very rare and unusual form of intraocular ossification. We report a case of choroidal osteoma in a young healthy male that to the best of our knowledge is the first report from India.

Telephone mouthpiece as a possible source of hospital infection.

A bacterial culture from telephone mouthpiece showed that 47 percent of the instruments carried pathogenic bacteria. Wiping with a disinfectant swab reduced the number of contaminated telephones. But for complete elimination of bacterial contamination changes in design of mouthpiece holes or type of instrument or using a polythene plastic cover over mouthpiece is recommended.

Cataract induced glaucoma--an insight into management.

The problem of phacomorphic glaucoma is a rather common entity in rural India owing to the delay in getting the cataract removed and the preponderance of cortical matter, compared with the Western world. The authors in India, South East Asia and Australia, have managed the problem differently leading to controversies. The pathogenesis has been investigated and is well understood. An aspect of phacomorphic glaucoma that remains quite unanswered, is of the relatively poor visual outcome and increased incidence of operative and post-operative complications. We endeavour to evaluate the management, intraoperative and post-operative complications of phacomorphic glaucoma (senile cataract induced). The effect of high intraocular pressure (I.O.P) and surgical trauma on the corneal endothelium is also assessed.

Iris neovascularization in Sturge-Weber syndrome.

An unusual case of Sturge-Weber syndrome with raised intraocular pressure is presented. The slit lamp examination and anterior segment fluorescein angiography were consistent with iris neovascularization. Cause and effect relationship of iris neovascularization with glaucoma in this syndrome is discussed.

Conjunctival microbial flora in leprosy.

Conjunctival sacs of seventy one leprosy patients, paramedical and medical personnel working in a leprosy home were cultured. None of these eyes had any pathology in the outer eye. Surprisingly, 46.2% of the eyes which showed a positive culture carried accepted pathogens; Staphylococcus aureus being the commonest. Determining the preoperative bacterial flora and their elimination before undertaking intraocular surgery is recommended.

SAFA test as an aid to the diagnosis of ocular tuberculosis.

A prospective double blind study was carried out to evaluate the role of soluble antigen fluorescent antibody (SAFA) test to detect ocular Tuberculosis. The study material comprised 39 patients with suspected ocular tuberculosis suffering from interstitial keratitis, sclero keratitis, granulomatous uveitis, phlyctenular keratoconjunctivitis, Eales disease and central serous retinopathy. The cases of proven ocular tuberculosis showed up as 70 percent strong reactors and 30 percent weak reactors to SAFA while none had a negative response to SAFA. Of these cases skin hypersensitivity reaction was positive only in 40 percent of the cases. The control group revealed a strong SAFA reaction in only 4 percent of cases with a weak reaction in 44 percent of cases. It thus appears that SAFA test can provide a useful addition to the routine tests in diagnosing tuberculosis.