Low semen quality and adverse histological changes in testes of adult male mice treated with bee venom (Apis mellifera).

Background: Male infertility has been on the rise since the past seven decades. Recently, in Libya, bee venom therapy (BVT) has become a popular method among alternative healthcare practitioners for treating male infertility. However, a literature search did not find any published studies that investigated the use of BVT for infertility treatment. Aim: To investigate the effect of bee venom on the male reproductive status through measurements of semen quality parameters and testicular histological changes in adult male mice. Methods: A total of 48 male mice were randomly divided into three experimental groups (which were subdivided into two subgroups with eight mice each) as follows: control, bee venom sting (BVS), and bee venom injection (BVI). The normal control subgroup mice were not subjected to any treatment, while the vehicle control subgroup mice were injected (i.p.) with 200 µl of 0.9% saline solution. In the BVS-treated subgroups, each mouse was stung by one live bee for five times (BVS-5) or seven times (BVS-7) every third day for 2 or 3 weeks. While each mouse in the BVI-treated subgroups received 23 µg/kg in a dose volume of 200 µl BVIs (i.p.) for five times (BVI-5) or seven times (BVI-7) every third day for 15 or 21 days. Results: The findings of this study showed that repeated bee venom treatment by sting or injection to adult male mice resulted in a significant decline in testosterone levels, sperm count, sperm motility, and a very significant increase in the percentage of abnormal sperm morphology; also, there were harmful testicular histological changes in the structural organization of seminiferous tubules and degenerative changes in the germinal epithelium compared to control group. Conclusion: The results of this study provide evidence for the low semen quality and adverse testicular histological changes in male mice treated with bee venom. Hence, there is a desperate need for educating alternative healthcare practitioners and infertile couples about the harmful effects of BVT on reproductive status.

Practice patterns of intraperitoneal chemotherapy in women with ovarian cancer.

OBJECTIVES: To determine the current patterns of IP chemotherapy use in women with ovarian cancer. METHODS: A survey concerning the use of intraperitoneal (IP) chemotherapy was sent to all members of the SGO listed in the 2005 SGO directory and to 200 members of ASCO randomly selected from the ASCO directory in two mailings. RESULTS: There were 209 completed responses to the survey, which included 24% of the SGO and 3% of the ASCO members sampled (P<0.0001). Of the respondents, 77% indicated that they currently offer IP chemotherapy, 14% either refer patients, or plan to offer IP chemo in the near future, and 9% do not offer IP chemotherapy. The top reasons given by those not using IP chemo was toxicity (63%) and not having the facilities to give an IP infusion (16%). Significant concern over toxicity by all respondents was highest for neurological toxicity (55%) followed by nausea and vomiting (51%), catheter infections (39%) and nephropathy (39%). The most common dose of IP cisplatin was 75 mg/m(2) (54%), followed by 100 mg/m(2) (38%). Only 6% use carboplatin primarily, but 60% reduce the cisplatin dose based on age. Currently 58% have modified the paclitaxel infusion to allow administration of this regimen in the outpatient setting and 17% plan to do so in the near future. Those using lower doses of platinum are also more likely to offer chemotherapy in the outpatient setting. Concern over toxicity, lack of coverage by residents or fellows, or type of practice did not predict a reduction in platinum dose. A single lumen IP catheter was used by 60% of respondents and a fenestrated is preferred by 40%. This catheter is placed at the time of primary surgery by 58% and 37% routinely place the catheter during a second procedure. CONCLUSION: The toxicity of IP therapy remains a concern and there does not appear to be any standard IP regimen that is used in women with ovarian cancer. The majority of the SGO members give IP chemotherapy in an outpatient setting at a dose lower than was used in clinical trials. This survey probably represents an overestimate in the use of IP therapy as there is likely a bias in completing the survey by those who currently use this modality. Based on this assumption, it appears that the use of IP chemotherapy by medical oncologists is low.

Prophylactic ip injection of bupivacaine and/or morphine does not improve postoperative analgesia after laparoscopic gynecologic surgery.

PURPOSE: To determine the effectiveness of ip bupivacaine and/or morphine for postoperative analgesia after laparoscopic surgery. A controversy exists on the effectiveness and clinical value of ip injection of local anesthetics for postoperative analgesia. A possible peripheral analgesic effect of morphine after ip injection remains debated as well. METHODS: We conducted a randomized, double-blinded, study to compare the efficacy of prophylactic ip administration of 0.9% saline (n = 16), 0.5% bupivacaine (100 mg, n = 15), morphine (3 mg, n = 16) and a mixture with 0.5% bupivacaine (100 mg) and morphine (3 mg, n = 18) to reduce both postoperative pain scores and analgesic requirements after gynecologic laparoscopic surgery. A multimodal analgesia regimen (acetaminophen, nonsteroidal anti-inflammatory drugs and morphine) was used for postoperative analgesia. RESULTS: No difference was observed in postoperative pain scores (visual analogue scale at rest and on coughing), or analgesic requirements during the first 24 postoperative hours between the four groups. There was also no significant intergroup difference in sedation scores and incidence of nausea and vomiting. CONCLUSION: When multimodal postoperative analgesia is used, prophylactic ip administration of 100 mg bupivacaine and/or 3 mg morphine does not significantly improve postoperative analgesia in patients undergoing laparoscopic gynecologic surgery.