The incidence of male reproductive failure leading to infertility, whether due to delayed parenthood, environmental issues, genetic factors, drugs, etc., is increasing throughout the world. The diagnosis and prognosis of male subfertility have become a challenge. While the basic semen assessment has been performed for many years, a number of studies question the value of the traditional semen characteristics. This is partly due to inadequate methods and standardization, limited knowledge of technical requirements for quality assurance, and an incomplete understanding of what clinical information a semen assessment can provide. Laboratories currently performing semen and endocrine assessment show great variability. The World Health Organization (WHO) manual for the evaluation of semen has been the core of andrology and fertility evaluation that has helped in further development of this field over many years. These include the physical appearance of the ejaculate, assessments of sperm count, motility, vitality, morphology, and functional aspects of the sperm and semen sample. These tests also include male endocrine profile, biochemical evaluation of the semen, detection of antisperm antibodies in serum, the use of computer-aided sperm analysis (CASA), sperm DNA integrity, and its damage due to oxidative stress. Assisted reproductive techniques (e.g., IVF, ICSI) have shown great success but are too expensive. Further development in this field with newer techniques and extensive training/instructions can improve accuracy and reduce variability, thus maintaining the quality and standards of such an evaluation. There is an urgent need to have standardized training centers and increased awareness in this area of men's health for reproductive success.

Patients with mandibular deficiency and skeletal class II malocclusions exhibit a wide spectrum of esthetic, cephalometric, and occlusal characteristics. The structure of chin determines facial attractiveness and is directly linked to a quality of life. Correction of dentoalveolar protrusion of maxilla is done by anterior maxillary subapical osteotomy by which anterior segment can be moved superiorly or inferiorly and posteriorly as indicated. Augmentation genioplasty is advocated to improve the overall facial esthetics of patient with mandibular deficiency. In skeletal class II malocclusions cases best results are obtained with double jaw surgery combined with the orthodontic treatment. This is a case report of skeletal class II malocclusion with mandibular deficiency and protruded maxilla in 22 year old female patient who was treated surgically by anterior maxillary subapical osteotomy and augmentation genioplasty along with the orthodontic treatment

Bone Neoplasms ; diagnosis ; secondary ; Carcinoma, Renal Cell ; diagnosis ; secondary ; Humans ; Kidney Neoplasms ; pathology ; Male ; Middle Aged ; Patella ; Sternum

Endocrine disruptors (e.g., polychlorinated biphenyls [PCBs], dichlorodiphenyl-trichloroethane [DDT], dioxin, and some pesticides) are estrogen-like and anti-androgenic chemicals in the environment. They mimic natural hormones, inhibit the action of hormones, or alter the normal regulatory function of the endocrine system and have potential hazardous effects on male reproductive axis causing infertility. Although testicular and prostate cancers, abnormal sexual development, undescended testis, chronic inflammation, Sertoli-cell-only pattern, hypospadias, altered pituitary and thyroid gland functions are also observed, the available data are insufficient to deduce worldwide conclusions. The development of intra-cytoplasmic sperm injection (ICSI) is beyond doubt the most important recent breakthrough in the treatment of male infertility, but it does not necessarily treat the cause and may inadvertently pass on adverse genetic consequences. Many well-controlled clinical studies and basic scientific discoveries in the physiology, biochemistry, and molecular and cellular biology of the male reproductive system have helped in the identification of greater numbers of men with male factor problems. Newer tools for the detection of Y-chromosome deletions have further strengthened the hypothesis that the decline in male reproductive health and fertility may be related to the presence of certain toxic chemicals in the environment. Thus the etiology, diagnosis, and treatment of male factor infertility remain a real challenge. Clinicians should always attempt to identify the etiology of a possible testicular toxicity, assess the degree of risk to the patient being evaluated for infertility, and initiate a plan to control and prevent exposure to others once an association between occupation/toxicant and infertility has been established.
Endocrine Disruptors ; pharmacology ; toxicity ; Environmental Pollutants ; Estrogens ; pharmacology ; toxicity ; Humans ; Infertility, Male ; chemically induced ; epidemiology ; Leydig Cells ; drug effects ; Male ; Reproduction ; drug effects ; Sertoli Cells ; drug effects ; Spermatogenesis ; drug effects

AIMTo assess the seminal characteristics as well as the sexual behavior of men of various age groups to establish the presence of an aging effect on those characteristics.

METHODSSemen samples were collected from men (n = 792) undergoing in vitro fertilization or intrauterine insemination in cases of female factor infertility only. Samples were collected using a seminal collection device at intercourse and evaluated manually according to World Health Organization (WHO) standards. Men were divided into four groups according to their ages: (i) 20-30, (ii) 31-40, (iii) 41-50 and (iv) 51-60 years, and their seminal characteristics and responses to a sexual behavior questionnaire were compared.

RESULTSThe data showed statistically significant differences in the seminal characteristics tested, most notably in the sperm concentration, motility, grade of motility, hypo-osmotic swelling and normal sperm morphology. Furthermore, the decline in normal sperm morphology with age was more pronounced when using strict criteria rather than WHO standards. There were also differences in total sperm count, total motile sperm and total functional sperm fraction (assessed by both WHO and strict criteria). Significant differences were also observed in the sexual behavior patterns in older men in terms of the number of years they have been trying to conceive, sexual frequency and sexual satisfaction.

CONCLUSIONThe data clearly illustrate an aging effect on semen characteristics and sexual behavior in men as they age. It is suggested that the aging effect be taken into consideration when proposing normal standard values for semen characteristics in routine semen analysis as outlined by WHO standards.

Adult ; Aging ; physiology ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; Insemination, Artificial ; Male ; Middle Aged ; Semen ; physiology ; Sexual Behavior ; physiology ; Sperm Count ; Sperm Motility ; physiology

BACKGROUND: Primary endobronchial smooth muscle tumors (SMTs), which are extremely rare, include endobronchial leiomyomas and leiomyosarcomas. Clinically, SMTs present with signs and symptoms of bronchial obstruction, and lack specific radiological findings. Thus, histopathological examination is required for accurate diagnosis as well as for tumor grading. We examined the histomorphological and immunohistochemical features of endobronchial SMTs and highlighted pitfalls in diagnosis, particularly when using small biopsies. METHODS: Cases of primary endobronchial SMTs diagnosed at our Institute over the last 6 years (2012–2017) were retrieved from the departmental archives. Histopathological features and immunohistochemistry performed for establishing the diagnosis were reviewed. RESULTS: Five cases of SMTs occurring in endobronchial locations were identified. These included three cases of leiomyoma, and two cases of leiomyosarcoma. The age distribution of patients ranged from 13 to 65 years. Leiomyomas showed more consistent staining with smooth muscle markers (smooth muscle actin, desmin, and smooth muscle myosin heavy chain), while tumors of higher grade showed variable, focal staining, leading to erroneous diagnosis, especially on small biopsies. CONCLUSIONS: The diagnosis of endobronchial SMTs relies on histopathological examination, for both confirmation of smooth muscle lineage and determination of the malignant potential of the lesion. Appropriate immunohistochemical panels including more than one marker of smooth muscle differentiation are extremely valuable for differential diagnosis from morphological mimics, which is necessary for instituting appropriate management.
Actins ; Age Distribution ; Biopsy ; Desmin ; Diagnosis ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Myosins ; Neoplasm Grading ; Smooth Muscle Tumor

ary phytochemical screening. The resultsshowed that the ethanolic crude extract of the leaf containhigh phytochemical activity hence B.oleraceavaracephalais rich in flavonoids, phenolic compounds, carbohydratesand phytosterols. Materials and methods: The ethanolic extract was used tosynthesise copper nanoparticles. The copper nanoparticleswere successfully synthesised from copper sulphatesolution which was identified by the colour change fromdark green colour of the extract. Thus the B.oleracea varacephala is a good source to synthesis coppernanoparticles. The synthesised copper nanoparticles werecharacterised using Scanning Electron Microscope (SEM)analysis. The SEM image displayed the high-densitynanoparticles synthesised by leaf extracts and that thenanoparticles were crystals in shape. Results: The copper nanoparticles (CNP) bind to the leafextract. B.oleraceavaracephalaalso has shown theantimicrobial and antioxidant activity. A comparative studywas done between ethanolic its crude extract andnanoparticles. Both extracts exhibited zone of inhibition andbetter antioxidant potential but the CuNPs shows majorzone of inhibition and showed more antioxidant activity.Anticancer activity of B.oleraceavaracephalaagainstCervical HeLa cell line was confirmed using ethanolic crudeextract and CNP. The results showed that HeLa cellsproliferation was inhibited with increasing concentration ofethanolic crude extract and copper nanoparticles. From theresults, it was seen that percentage viability of the cancercells decreased with increased concentration of the sampleswhereas cytotoxicity against HeLa cell lines increased withthe increased concentration of the samples. Conclusion: Thus B.oleraceavaracephalapossessesanticancer activity against HeLa cell lines.

Congenital alveolar synechiae is a rare anomaly mostly presenting in association with cleft palate. Owing to reduced mouth opening, feeding difficulties, and compromised airway in extreme cases along with presentation in early neonatal period, these patients present unique challenges to the surgeon as well as the anesthetist. Here, we discuss the surgical and anesthetic management of this entity in a 12-month-old female child.
Child ; Cleft Palate ; Female ; Humans ; Infant ; Mouth ; Trismus*