Toxic metals signature in the human seminal plasma of Pakistani population and their potential role in male infertility.

Aims of this study were to provide firsthand data on the incidence of trace metals in human seminal plasma and find possible correlations between levels of toxic metals and semen quality of Pakistani population. Human semen samples were collected from male partners of couples undergoing infertility assessment at the National Institute of Health Islamabad (Pakistan). We investigated seventy-five seminal plasma samples, which were further categorized into three groups (normozoospermia, oligozoospermia and azoospermia) according to WHO guidelines. The concentration of 17 different toxic metals in human seminal plasma was determined simultaneously by using Inductively coupled plasma mass spectrometry (ICP-MS). Out of 17 trace metals, Cd and Ni showed significant difference (p < 0.05) among three monitored groups. Ni and Cd concentrations in the seminal plasma were negatively correlated with sperm concentration (r = -0.26, -0.29) and motility (r = -0.33, -0.37), respectively. This study suggested that exposure of Ni and Cd is mainly related with the consumption of contaminated dietary items, including ghee (cooking oil), flour and other agri-products. In some semen samples, the concentrations of Sn, V, Cu, Pb, Cr and Hg exhibited high levels suggesting a recent human exposure to surrounding sources. In Pakistani human semen samples, the levels of trace metals were lower and/or comparable to that found in populations of other countries. The results show the first evidence of the effect of toxic metals on semen quality and male infertility in Pakistan.

Morphometrical analysis of intervillous space and villous membrane thickness in maternal anaemia.

BACKGROUND: Anaemia in pregnancy is linked with an increased risk of preterm delivery, low birth weight, perinatal and maternal mortality and it is related with variable histo-morphological changes in placenta which show a reflection for the poor foetal outcome. The objective of this study is to assess the micro-morphometery of intervillous space and villous membrane of placenta in anaemic mothers. METHODS: This case control study was carried out at Army Medical College, National University of Sciences and Technology Islamabad in collaboration with Department of Obstetrics and Gynaecology, Military Hospital, Rawalpindi, Pakistan, from December 2011 to November 2012. A total of 75 placentas were included, that were divided into study and control group. In control group (n = 15) placentas were taken from mothers having normal haemoglobin levels and study group (n = 60) included placentas from anaemic mothers having haemoglobin less than 11g/dl. Study group was subdivided into three groups, i.e., mildly (10.0-10.9 g/dl), moderately (7.0-9.9 g/dl) and severely (< 7 g/dl) anaemic group. Three representative sections were taken from placenta, i.e., one close to umbilical cord (A), one from periphery (C) and one midway between A and C (B).Ocular micro-meter was used to measure intervillous space and villous membrane thickness. RESULTS: Intervillous space was prominent in study groups (41.26 ± 16.33 ìm) as compared to control group (15.98 ± 3.81 ìm) (p < 0.05). Thickness of villous membrane was significantly less in study group as compared to control group (2.97 ± 0.70) (p < 0.05). CONCLUSION: The present study showed wide intervillous space and thin villous membrane in study group as compared to control group reflecting adaptive changes in response to hypoxiain maternal anaemia.

Diagnostic accuracy of endometrial curettage in endometrial pathology.

BACKGROUND: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Uterine curettage or biopsy remains a preferred sampling procedure for diagnosis of the endometrial pathology. The objective of this study was to compare the sensitivity, specificity, positive and negative predictive value of endometrial curettage. PATIENTS AND METHODS: This validation study was carried out at the Department of Histopathology, Army Medical College Rawalpindi in collaboration with Military Hospital, Rawalpindi from January to December 2010. The study included 50 curettage and subsequent hysterectomy specimen of the same patients. Non-probability sampling technique was used to divide patients into two groups with 50 patients in each group. One group was of endometrial curettage having endometrial pathology (group A). Second group was of subsequent hysterectomy specimen of the same patients (group B). RESULTS: Endometrial curettage was found most accurate in diagnosing endometrial carcinoma. Sensitivity of endometrial curettage was found to be 33% whereas specificity and positive predictive value was found to be 100% each. Negative predictive value was found to be 93.1%. CONCLUSION: Endometrial biopsy is a sensitive and a specific test in and is accurate in diagnosing endometrial pathology. It is found most accurate in diagnosing endometrial carcinoma.

Histopathological and Immunohistochemical Analysis of Small Intestinal Biopsies in Adults Suspected of Celiac Disease.

OBJECTIVE: To analyse histomorphological and immunohistochemical analysis of small intestinal biopsies in adults suspected of celiac disease. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Histopathology, Army Medical College, Rawalpindi, from November 2014 to December 2015. METHODOLOGY: Fifty cases of small intestinal mucosal biopsies (duodenal and jejunal) were analysed in adult patients aged above 14 years suspected of celiac disease. Their histomorphological data was recorded using Modified Marsh Criteria. Type of intraepithelial lymphocytes was assessed using immunohistochemistry. Intraepithelial lymphocytes were counted both by H&E stain and immunostain CD3 and CD20. RESULTS: Thirty-four percent patients were aged between 21 - 30 years and 22% patients aged between 41 - 50 years. There were 84% (n=42) males. Thirteen (26%) cases showed focal villous atrophy, 32 (64%) cases showed partial villous atrophy and 5 (10%) cases showed complete villous atrophy. Anti-tissue transglutaminase antibody was positive in 21 (42%) cases. CD3 immunomarker was positive for intraepithelial lymphocytes in all 50 cases while CD20 immunomarker showed focal positivity in areas with lymphoid follicle formation. The count of intraepithelial lymphocytes was found to be almost equal (with a difference of 3 - 4 lymphocytes) on both H&E stain and immunostain CD3 and CD20. CONCLUSION: Males aged 21 - 30 years were the most commonly affected group. The most frequent change in histology was partial villous atrophy along with lymphocytic enteritis. All the intraepithelial lymphocytes were present in crescendo pattern of distribution.