Survey of semen analysis practices in India and need for standardization and improvement

Background and Objectives: Infertility is a sensitive subject carrying with it economic, social, and psychological implications. Work up of male infertility is often hampered by a lack of infrastructure and facilities, as well as inadequate training of pathology residents. The purpose of this research survey was to evaluate the current status of semen analysis practices and compare them to the standards laid down by the World Health Organization (WHO). Materials and Methods: A web-based questionnaire was designed consisting of questions related to semen analysis practices and procedures being followed currently by pathologists in India. A total of 194 pathologists responded. Questions regarding the procedures followed for semen collection, sperm count, volume, normal range, lower normal limit of sperm count, morphology, etc., were included in the survey. These data were recorded. The differences and gaps in the practice with respect to the WHO standards were analyzed. Results: The survey revealed that the printed instructions for semen analysis were available with 38.7% of the respondents; 58.8% of the respondents had a separate room for semen collection; 95.9% performed the analysis manually, and; only 4.1% used automated analyzers. Only 53.6 and 52.6% of the respondents were correctly reporting the normal range of semen volume and sperm counts, respectively. Only 19.6% stated as having read the WHO manual and were also practicing its guidelines, while 14.4% had not read the WHO manual even once. Conclusion: The present study showed a large gap between the practice of semen analysis by respondents from various parts of India and standard procedures as laid down by the WHO. Many laboratories do not follow the standard instructions. There is a need to improve the quality of practice related to semen analysis in this country through appropriate teaching and training in medical institutions as well as through Continuing Medical Education (CMEs) or regular update programs.

A New Chromogenic Spray Reagent for Detection and Identification of Indoxacarb in Visceral Material by HPTLC

There is inherent rise of pesticide poisoning in India. Among all these pesticide indoxacarb is registered for use to control lepidopteran insects on crops, turf grasses, and landscape ornamentals. A novel chromatographic reagent is described for detection and identifications of Indoxacarb by HPTLC by use of furfural reagent. Indoxacarb (I) on acid hydrolysis yield its metabolites namely 4-trifloro-methoxy-phenyl amine (II), Oxidiazine (III) and acetic acid (IV). The 4-trifloro-methoxy-phenyl amine (II) under acidic condition reacts with furfural which gives grayish black colored spot on heating. The constituents of viscera (amino, acids, peptides, proteins, etc.) and plant materials do not interfere with the test. The detection limit for Indoxacarb is 0.5?g. The reaction mechanism is discussed. The necessary HPTLC parameter like concentration of analyte also mentioned for the efficient detection of indoxacarb pesticide.

Drug utilization review of anticancer drugs in cancer outpatient department of the Government Medical College, Aurangabad.

Background: To study drug utilization of anticancer drugs in cancer outpatient department (OPD) of Government Medical College, Aurangabad. Methods: Five hundred and twelve prescription records were screened and analyzed as per the study parameters from cancer OPD of Government Medical College and Hospital, Aurangabad. Commonly used anticancer drugs were recorded; furthermore, different types of carcinomas were noted. Results: Age group of patients was in between 30 and 70, 267 were females and 245 were male patients. The most common type of carcinoma was carcinoma of the breast (17.9%). Carboplatin was the most commonly used anticancer drug (26.56%). The average number of anticancer drugs received per patient was three. Conclusion: WHO suggested drug utilization studies are needed in every health care setting. For a developing country like India, National Drug Policy and Drugs and Therapeutic Committee are a must.

Health monitoring of farm labourers engaged in MIPC 50 WP field sprays.

Investigations were undertaken to monitor the health status of farm labourers engaged in field sprays of MIPC 50 WP (Hexamicin, Mipcin), a carbamate insecticide on cotton crop, as per the protocol approved by the Central Insecticide Board The insecticide sprays (0.1%) were undertaken for six hr on three consecutive days on 1.2 hectares of cotton crop per day, using Aspee napsak sprayers. The spray personnel (mixers, loaders and sprayers) with protective clothing did not reveal any alteration in clinical, hematological and blood bio-chemical profile during exposure and post exposure periods. The spray personnel without protective clothing showed only a marginal reduction in their blood cholinesterase activity during the exposure period.

Studies on the effect of isoprocarb (MIPC 50 WP) on livestock.

Different species of livestock was exposed to isoprocarb (MIPC 50 WP) sprays to monitor their health status. Exposure of livestock (calves, sheep, dogs and RIR birds) to 0.1 percent isoprocarb sprays on cotton crop for 6 hours a day for three consecutive days, showed no adverse effects on evident from clinical hematological and biochemical observations.

The pattern of 'drop-out' of smear-positive cases at an urban leprosy centre.

One hundred nineteen smear-positive leprosy cases registered at an urban leprosy centre in Bombay in 1991 were followed for three years to study the 'drop-out' pattern in them and judge the utility of some corrective measures for the same. The measures included having maps showing exact location of the patient's residence, paying home visits on registration days and subsequent persuasion and counselling both at the clinic and at the residence of patients. The results were compared with 'drop-out' in smear-positive cases registered at the same centre in 1989, 1990, 1992 and 1993. By introduction of the special measures, the 'drop-out' rate was significantly reduced from 52% (for other years) to 36% (1991). The expenses incurred for the successful recovery of 'drop-out prone' patients and ensuring regularity in drug intake was Rs. 659/- per patient. This study of 'drop-out' patient shows that there are three categories of the so-called drop-outs: (i) the false 'drop-outs' (51%): these patients get transfer as per their convenience to other leprosy centres or medical services (private practitioners or consultants) within the city (ii) drop-outs due to migration: the migration is forced on them due to some genuine reason, and (iii) persistent offenders: this is a group of adamant, non co-operative, or, distressed patients. For the first two category of patients it is advisable to introduce a good referral system. For the recalcitrant defaulters, supervised short-term drug therapy will probably be the best option.