Clinical Relevance of Oxidation-Reduction Potential in the Evaluation of Male Infertility.

OBJECTIVE: To evaluate (1) the relationship between oxidation-reduction potential (ORP) and abnormal sperm quality, and (2) the changes in ORP and sperm parameters over time, in search of a potential surrogate marker of poor sperm quality that may assist in the diagnosis of oxidative stress-related male infertility. MATERIALS AND METHODS: A total of 194 infertile men were included and 28 patients were identified to have repeated semen analyses and ORP measurements. The semen samples obtained were categorized into normal and abnormal sperm parameters based on the World Health Organization's fifth edition guidelines. Wilcoxon tests were used to compare the results of different groups. Correlations were analyzed by the Spearman rank-order correlation and receiver operating characteristic analysis was used to estimate optimal ORP cutoffs for identifying abnormalities. RESULTS: ORP levels were significantly elevated in semen samples with abnormal sperm parameters. ORP at a cutoff of 1.57 (mV/106 sperm) was able to detect at least 1 abnormal sperm parameter with a sensitivity of 70.4% and a specificity of 88.1%. ORP at a cutoff of 2.59 (mV/106 sperm) had the highest predictive value in detecting oligozoospermia with 88% sensitivity and 91.2% specificity. The increases in sperm concentration and motility in patients tested for semen analysis at 2 consecutive time intervals were related to a decline in ORP levels. CONCLUSION: ORP is a reliable method in predicting poor sperm quality. The introduction of ORP in male infertility evaluation may help overcome the high technical variability of semen analysis and assist in the diagnosis of oxidative stress-related infertility.

Chlorhexidine Anaphylaxis Masquerading as Septic Shock.

Chlorhexidine is a commonly used antiseptic and disinfectant in the health-care setting. Its usage has increased in recent years with intensive campaigns and infection control guidelines to combat hospital-acquired infections. As a result, patients and health-care workers (HCW) are exposed to increasing chlorhexidine usage. In recent years, adverse reactions to chlorhexidine ranging from allergic contact dermatitis, photosensitivity, fixed drug eruptions, urticaria and anaphylactic shock have been reported. Most have been isolated case reports on adverse reactions occurring in healthy individuals or HCW. We report a case of anaphylactic shock caused by applying chlorhexidine cleansing solution and masquerading as septic shock from left-leg necrotising fasciitis.