Resolving Secondary Infertility: A Case Report of the Successful Treatment of Sperm DNA Fragmentation Through the Physiological Intracytoplasmic Sperm Injection Method.

This case report presents an illustrative account of a couple experiencing secondary infertility attributed to the fragmentation of DNA in sperm. Secondary infertility, the inability to conceive after having previously successfully conceived a child, can be due to various factors, including male infertility issues. Sperm DNA fragmentation (SDF) has emerged as a major factor influencing male fertility, resulting in poor embryo development and lower pregnancy rates. This case is about the use of advanced assisted reproductive technologies, specifically physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI), to treat secondary infertility caused by fragmentation of sperm DNA. PICSI enables the identification and selection of spermatozoa with optimal functional integrity using hyaluronan, a natural binding substance. Preparing a PICSI dish requires skill and precision. Sperm exhibiting a high DNA fragmentation index were excluded from the selection process to enhance embryo development potential. The couple underwent controlled ovarian stimulation, egg retrieval, and ICSI with PICSI. The treatment resulted in the successful conception of a singleton pregnancy. Subsequent prenatal monitoring indicated a healthy pregnancy progression, ultimately culminating in the delivery of a healthy baby girl at term. This case report highlights the efficacy of integrating PICSI as a sperm selection method preceding ICSI, specifically in cases of secondary infertility related to SDF. Further research and larger-scale studies are warranted to approve the findings of this case report and establish the broader applicability of this treatment approach.

Revolutionizing Medical Microbiology: How Molecular and Genomic Approaches Are Changing Diagnostic Techniques.

Molecular and genomic approaches have revolutionized medical microbiology by offering faster and more accurate diagnostic techniques for infectious diseases. Traditional methods, which include culturing microbes and biochemical testing, are time-consuming and may not detect antibiotic-resistant strains. In contrast, molecular and genomic methods, including polymerase chain reaction (PCR)-based techniques and whole-genome sequencing, provide rapid and precise detection of pathogens, early-stage diseases, and antibiotic-resistant strains. These approaches have advantages such as high sensitivity and specificity, the potential for targeted therapies, and personalized medicine. However, implementing molecular and genomic techniques faces challenges related to cost, equipment, expertise, and data analysis. Ethical and legal considerations regarding patient privacy and genetic data usage also arise. Nonetheless, the future of medical microbiology lies in the widespread adoption of molecular and genomic approaches, which can lead to improved patient outcomes and the identification of antibiotic-resistant strains. Continued advancements, education, and exploration of ethical implications are necessary to fully harness the potential of molecular and genomic techniques in medical microbiology.

Adolescent Sexual Behavior in Rural Central India: Challenges and Interventions.

Adolescence is a crucial life stage marked by significant physical, psychological, and societal changes. With India projected to have the highest population of teenagers by 2025, understanding adolescent sexual behavior in rural central India is essential due to its unique social and cultural contexts. This article reviews existing literature to explore the prevalence, risk factors, and consequences of teenage sexual behavior in rural central India. It highlights the challenges posed by societal taboos, limited access to sexual health information and services, and the impact of poverty on adolescents' sexual behavior and health outcomes. To address these issues, comprehensive sex education, improved access to contraception and reproductive health services, and efforts to overcome cultural and societal norms are crucial. The article discusses the initiatives undertaken by the government and non-governmental organizations (NGOs) to tackle adolescent sexual behavior and emphasizes the need for a multifaceted approach that addresses systemic issues while empowering adolescents. It concludes by suggesting future research directions and policy recommendations aimed at promoting safe sexual behavior among rural adolescents in central India. This article will discuss the complexity of adolescent sexual behavior in rural central India, its origins, and the challenges faced by medical decision-makers.

Emerging and Re-Emerging Viral Infections: An Indian Perspective.

Emerging and re-emerging viral infections pose a constant threat, especially in healthcare settings. Viral infections can be thought of as an ecological system, like a forest or a pond, with different species competing for resources. Pandemics tend to occur when there is a disruption to this ecosystem, such as introducing a strain of virus into humans or animals that they have no immunity against. Around 60% of human infectious diseases and 75% of emerging infections are zoonotic, with two-thirds originating in wildlife. There is an ongoing risk of viral diseases as the human population continues to grow and the rate of urbanization increases. The emergence and re-emergence of viral diseases are influenced by a variety of virologic and environmental factors. These factors can be roughly categorized as affecting humans, the environment and/or ecology, and viruses. The spread of zoonotic diseases among humans can be prevented by reducing the transmission risk associated with wildlife and exotic pets through education, legislation, and behavioral change programs that target individuals at risk for exposure.

Assessment of health status and impact of pollution from thermal power plant on health of population and environment around the plant in Udupi District, Karnataka.

Background: Coal-fired thermal power plants (TPPs) have a serious impact on soil, air, and water quality resulting in deterioration of health and environment around the plant. Objective: The present study was undertaken with the objectives of assessing the respiratory health status of the population around the plant and to measure selected heavy metals in fly ash, air, water, and soil samples. Materials and Methods: The current cross-sectional study was conducted among 3533 adult residents living in two strata within 10 km radius around the TPP in Udupi district of Karnataka state. Data were collected by using semi-structured questionnaire and spirometry and environmental air monitoring by DustTrak aerosol monitor, water, and soil samples were collected for analysis. Results: Majority of the study participants were in the age group of >45 years (41.4%). 70.6% were females and 0.39% were trans-genders. 4.3% were suffering from various respiratory problems. Bivariable logistic regression showed subjects aged 46-65 years and >65 years have 2.91 times and 4.42 times higher odds of respiratory disease as compared to those with age ≤45 years. Multivariable logistic regression showed significant association between higher age group (P < 0.0001) and in subjects who had closed window during cooking (P < 0.006). Levels of heavy metals in soil samples and particulate matter 2.5 were well within permissible limits whereas the ground water samples had excess levels of iron, manganese, and copper. Conclusion: The present study has implications for policymaking to protect the environment and health of vulnerable populations in industrial clusters and the vicinity of power plants.

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Appropriate volume assessment and fluid management can prevent maternal deaths in the severely pre-eclamptic (SPE) parturients. We planned a systematic review and meta-analysis (MA) to evaluate the role and ability of point-of-care ultrasound (POCUS) in the assessment of volume status and early detection of lung oedema in an SPE parturient. METHODS: An e-literature search was done from several databases. Data were extracted under five domains including POCUS-derived parameters like echo comet score (ECS), lung ultrasound (LUS) scores, B-patterns, optic nerve sheath diameter (ONSD), E/e' ratio, presence of pleural effusion, pulmonary interstitial syndrome and pulmonary congestion. The risk of bias was assessed. Extracted data were analysed using MetaXL and Revman 5.3. Heterogeneity in the studies was evaluated using the Cochrane Q test and I2 statistics. Funnel plots were used for the assessment of publication bias. RESULTS: Seven prospective studies including 574 parturients (including 396 pre-eclamptics) were selected. POCUS included lung, optic nerve, cardiac and thoracic US. In two studies, the ECS and LUS scores pre-delivery were higher in pre-eclamptics. Two studies found a mean ONSD of 5-5.84 mm before delivery. MA revealed a significantly lower mean ECS score at post-delivery than pre-delivery, and the summary prevalence of B-pattern and pleural effusion among SPE parturients was found to be 0.28 (0.03-0.84) and 0.1 (0-0.2), respectively. A good correlation was observed between B-line patterns and diastolic dysfunction (increased E/e' ratio), LUS score and thoracic fluid content, ONSD and ECS in individual studies. CONCLUSION: POCUS parameters can be useful as early markers of fluid status and serve as useful tools in the precise clinical management of pre-eclampsia.

Ultrasonographic Estimation of Endotracheal Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study.

INTRODUCTION: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. AIM: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. The secondary outcome was to assess the number of times the tube was changed based on air leak test for USG estimated tube size. MATERIALS AND METHODS: After ethical committee approval, a prospective clinical observational study for a period of one year was conducted on 75 children (power of study 80%, confidence interval 95%) aged one to 14 years of American Society of Anaesthesiologists Physical Status (ASA) I and II undergoing elective surgery under general anaesthesia with orotracheal intubation. Parental consent was obtained. Pre-anaesthetic ultrasonography was performed on every patient at the subglottic region. The tracheal subglottic diameter was estimated to select the ETT size for cuffed and uncuffed tubes. The size estimated by USG and that based on age and height based formulae were compared with clinically used appropriate tube size. Data analysis was done using IBM Statistical Package for the Social Sciences (SPSS) version 20.0; One-way Analysis of Variance (ANOVA) and t-test for comparison were used. RESULTS: USG predicted the appropriate ETT size (p<0.05) better than physical indices based formulae for cuffed and uncuffed tubes. The age based formula predicted the clinically used ETT size well (p=0.58) and the height based formula did not correlate with clinically used tube size (p=0.0002 - a statistically significant value). Eight patients required change of tube once. CONCLUSION: Ultrasonographic estimation of subglottic diameter is useful for optimal paediatric ETT size selection. USG is effective in estimating the appropriate sized ETT both for cuffed and uncuffed tubes.

The promising anticancer drug 3-bromopyruvate is metabolized through glutathione conjugation which affects chemoresistance and clinical practice: An evidence-based view.

3-Bromopyruvate (3BP) is a promising effective anticancer drug against many different tumors in children and adults. 3BP exhibited strong anticancer effects in both preclinical and human studies e.g. energy depletion, oxidative stress, anti-angiogenesis, anti-metastatic effects, targeting cancer stem cells and antagonizing the Warburg effect. There is no report about 3BP metabolism to guide researchers and oncologists to improve clinical practice and prevent drug resistance. In this article, we provide evidences that 3BP is metabolized through glutathione (GSH) conjugation as a novel report where 3BP was confirmed to be attached to GSH followed by permanent loss of pharmacological effects in a picture similar to cisplatin. Both cisplatin and 3BP are alkylating agents. Reported decrease in endogenous cellular GSH content upon 3BP treatment was confirmed to be due to the formation of 3BP-GSH complex i.e. GSH consumption for conjugation with 3BP. Cancer cells having high endogenous GSH exhibit resistance to 3BP while 3BP sensitive cells acquire resistance upon adding exogenous GSH. Being a thiol blocker, 3BP may attack thiol groups in tissues and serum proteins e.g. albumin and GSH. That may decrease 3BP-induced anticancer effects and the functions of those proteins. We proved here that 3BP metabolism is different from metabolism of hydroxypyruvate that results from metabolism of D-serine using D-amino acid oxidase. Clinically, 3BP administration should be monitored during albumin infusion and protein therapy where GSH should be added to emergency medications. GSH exerts many physiological effects and is safe for human administration both orally and intravenously. Based on that, reported GSH-induced inhibition of 3BP effects makes 3BP effects reversible, easily monitored and easily controlled. This confers a superiority of 3BP over many anticancer agents.

Current views and practice of faculty members and consultants regarding 'Publications in India': A cross-sectional study.

BACKGROUND AND AIMS: There is an increasing enthusiasm and pressure to submit scientific articles to journals for publication due to official policies. This has led to increased stress on authors and editors and in issues like plagiarism. We planned a cross-sectional study with an aim to explore the current publication related views and practice of faculty members and consultants. METHODS: We conducted a questionnaire based prospective survey with 22 questions divided into parts. Print and electronic versions were sent to around 18,270 members in total, a majority of whom were anaesthesiologists and 600 members responded to our questionnaire. A database was created and analysed using Microsoft Excel. RESULTS: About 80% felt that online journals were better read than print journals. Eighty eight percent agreed that publications improve academic skills. The Medical Council of India requirements to publish in reputed journals were cited as the main reasons for plagiarism. The publication rule had become a burden for 46% respondents. Review articles were most likely to be read though clinical investigations were considered to be of maximum academic significance. Review/publishing time followed by author requirements and journal indexing were the points our respondents liked to see most when choosing a journal for article submission. CONCLUSION: Our survey results depict the current author related views and trends in publication practice which may guide in evidence-based policy making.

A model of the generation and transport of ozone in high-tension nozzle driven corona inside a novel diode.

The genesis and transport of ozone (O(3)) are investigated in a novel plasma diode and described in this paper. The innovative cathode (K) of this axial symmetric diode which operated at the high voltage (φ(0)), has a large number of sharpened nozzles located on different radial planes of its central tubular-mast and is encircled by the anode (A). The nozzles played the dual role of oxygen (O(2)) injection as well as creation of high electric field (E) in the A-K gap, enabled the formation of a cold corona. Electrons in the corona under the influence of E moved towards anode, collided with O(2) and created the O radicals. O in turn joined the free O(2) and formed O(3). The evolution of O(3) here is modeled in various O(2) pressure (P), electron density (n(e)), and temperature (T) in terms of the major reaction modes involving e, O, O(2), and O(3). Typical steady state O(3) density attained so in P ~ bar, n(e) ~ 10(15) m(-3) and T ~ 300 K is over 10(25) m(-3) and that of O lower ~10(20) m(-3). Both the O and O(3) densities increased with an enhanced n(e) of avalanche multiplications in corona. O(3) increased also with a higher P but the temporal O reversed in trend midway and reduced with P towards the steady state. A sharp decline in diode resistance with smaller A-K gap induced finite discharge current and led to the undesired heating of corona. It is shown that the O(3) density reduced with the temperature rise but O density reduced with the T rise up to 500 K and then rose modestly with the further T increase.

An efficient analytical method for analysis of spirotetramat and its metabolite spirotetramat-enol by HPLC.

Spirotetramat is a new compound which belongs to the chemical class of ketoenols. As per the available literature analysis of spirotetramat and its metabolites spirotetramat-enol is carried out by high pressure liquid chromatograph with mass spectrometry (HPLC-MS/MS). In this study we have standardized a method where analysis of both the compounds is carried out by HPLC. The extraction and cleanup of spirotetramat and its metabolites spirotetramat-enol was carried out by QuEChERS method. The cleaned up residues were estimated by HPLC equipped with a photo diode array detector at a wavelength of 250 nm. The mobile phase used was acetonitrile: water at a proportion of 40:60. The limit of quantification (LOQ) of the method was 0.05 mg kg(-1) for both spirotetramat and its metabolite spirotetramat-enol. The recoveries of both the compounds at the LOQ level were in the range of 72.72%-86.76% from mango and 74.82% to 86.92% from cabbage.

Behavior of beta cyfluthrin and imidacloprid in/on mango (Mangifera indica L.).

Residue persistence of beta cyfluthrin and imidacloprid on mango was carried out after giving spray application of the combination formulation, beta cyfluthrin 9% + imidacloprid 21% (Solomon 300 OD) 3 times at the fruit formation stage. The treatments were, untreated control, standard dose of 75 g a.i. ha(-1) and double dose of 150 g a.i. ha(-1). Initial residues of beta cyfluthrin on mango fruits were 0.04 and 0.12 mg kg(-1) from treatments at the standard and double doses, respectively. The residues dissipated with the half-life of 2.4 and 2.6 days and persisted for 5 days only. Initial residues of imidacloprid on mango fruits were 0.14 and 0.18 mg kg(-1) from treatments at the standard and double doses, respectively. Imidacloprid residues degraded with the half-life of 3.06 and 4.16 days, respectively and persisted for 10 days. Mature mango fruits at harvest were free from residues of both insecticides. A safe pre-harvest interval of 8 days is recommended for consumption of mango fruits after treatment of the combination formulation.

Development of an analytical method for analysis of flubendiamide, des-iodo flubendiamide and study of their residue persistence in tomato and soil.

Flubendiamide is a new insecticide that has been found to give excellent control of lepidopterous pests of tomato. This study has been undertaken to develop an improved method for analysis of flubendiamide and its metabolite des-iodo flubendiamide and determine residue retention in tomato and soil. The analytical method developed involved extraction of flubendiamide and its metabolite des-iodo flubendiamide with acetonitrile, liquid-liquid partitioning into hexane-ethyl acetate mixture (6:4, v v⁻¹) and cleanup with activated neutral alumina. Finally the residues were dissolved in gradient high pressure liquid chromatography (HPLC) grade acetonitrile for analysis by HPLC. The mobile phase, acetonitrile-water at 60:40 (v v⁻¹) proportion and the wavelength of 235 nm gave maximum peak resolution. Using the above method and HPLC parameters described, nearly 100 % recovery of both insecticides were obtained. There was no matrix interference and the limit of quantification (LOQ) of the method was 0.01 mg kg⁻¹. Initial residue deposits of flubendiamide on field-treated tomato from treatments @ 48 and 96 g active ingredient hectare⁻¹ were 0.83 and 1.68 mg kg⁻¹, respectively. The residues of flubendiamide dissipated at the half-life of 3.9 and 4.4 days from treatments @ 48 and 96 g a.i. ha⁻¹, respectively and persisted for 15 days from both the treatments. Des-iodo flubendiamide was not detected in tomato fruits at any time during the study period. Residues of flubendiamide and des-iodo flubendiamide in soil from treatment @ 48 and 96 g a.i. ha⁻¹ were below detectable level (BDL, < 0.01 mg kg⁻¹) after 20 days. Flubendiamide completely dissipated from tomato within 20 days when the 480 SC formulation was applied at doses recommended for protection against lepidopterous pests.

Persistence and dissipation of flubendiamide and des-iodo flubendiamide in cabbage (Brassica oleracea Linne) and soil.

Flubendiamide belongs to a novel class of insecticide which controls lepidopteran pest complex of cabbage such as diamondback moth, cabbage white butterfly, cluster caterpillar etc. Being a newly introduced insecticide no information is available on its residue persistence in cabbage. A study was undertaken to evaluate the residue persistence of flubendiamide in cabbage and soil following 2 applications of flubendiamide 480 SC at the recommended and double the recommended dose of 24 and 48 g a.i. ha(-1). Initial residue deposits of flubendiamide in cabbage were 0.33 and 0.49 mg kg(-1) respectively. The residues persisted for 10 days from the both the treatments and dissipated with the half-life of 3.9 and 4.45 days, respectively. Des-iodo flubendiamide, a metabolite of flubendiamide, was not detected in cabbage at any time during the study period. Soil sample collected from the treated field after 15 days was free from any residue of flubendiamide or its metabolite.

Behaviour of trifloxystrobin and tebuconazole on grapes under semi-arid tropical climatic conditions.

BACKGROUND: A mixture of trifloxystrobin and tebuconazole is excellent in controlling both powdery and downy mildew of grapes. The objective of the present work was to study the behaviour of trifloxystrobin and tebuconazole on grape berries and soil following treatment with Nativo 75 WG, a formulation containing both fungicides (trifloxystrobin 250 + tebuconazole 500 g kg(-1)). This study was carried out for planned registration of this mixture for use on grapes in India. RESULTS: Initial residue deposits of trifloxystrobin and tebuconazole on grapes were below their maximum residue limit (MRL) of 0.5 and 2 mg kg(-1), respectively, when Nativo 75 WG was applied at the recommended dose of 175 g product ha(-1). The residues dissipated gradually to 0.02 and 0.05 mg kg(-1) by 30 days, and were below the quantifiable limit of 0.01 mg kg(-1) at the time of harvest (60 days after the last treatment). Trifloxystrobin and tebuconazole dissipated at a pre-harvest interval (PHI) of 36 and 34 days, respectively, from the recommended treatment dose. The acid metabolite of trifloxystrobin, CGA 321 113, was not detected in grape berries at any point in time. Soil at harvest was free of any pesticide residues. CONCLUSION: Residue levels of both trifloxystrobin and tebuconazole were below MRLs when grapes were harvested 30 days after the last of four applications of 175 g product ha(-1) (trifloxystrobin 44 g AI ha(-1), tebuconazole 88 g AI ha(-1)) under the semi-arid tropical climatic conditions of India.