Comparison of the effect of Ceratonia siliqua L. fruit oral capsule and vitamin E on semen parameters in men with idiopathic infertility: a triple-blind randomized controlled clinical trial.

OBJECTIVES: To compare the effect of oral Ceratonia siliqua (Carob) and vitamin E on sperm parameters in idiopathic infertile men. METHODS: In this triple-blind randomized controlled trial study, fifty 20-45-year-old infertile men with idiopathic abnormal sperm parameters were selected among men referring to the infertility clinic of Al Zahra-Iran Hospital, and randomly allocated into two groups. The first group received Carob capsules, 500 mg, and the second group received vitamin E capsules three times a day for 90 days. The primary outcomes of this study were the sperm parameters (count, motility, and morphology). RESULTS: After the intervention, the mean of sperm count increased from 49.08 to 60.22 million/mL in the carob vs. it increased from 47.64 to 58.88 million/mL in the vitamin E group (adjusted mean difference (aMD)=1.124 million/ml, 95% CI: -12.892 to 15.141). The mean sperm motility increased from 45.90 to 52.90% in the carob group but decreased from 55.23 to 38.10% in the vitamin E group (aMD=17.22%, 95% CI: 8.53 to 25.92). The mean sperms with normal morphology increased from 11.52 to 67.05% in the carob, and from 10.20 to 77.47% in the vitamin E group (aMD=-10.88%, 95% CI: -22.30 to 0.536). There was no serious side effect during the treatment course. CONCLUSIONS: Taking 1,500 mg oral dose of Carob capsule per day for 90 days improved sperm motility but had no significant effect for improving morphology and count comparing to vitamin E capsule.

Effect of age on semen parameters in infertile men after varicocelectomy.

BACKGROUND: The effectiveness of varicocelectomy in restoration of fertility and improvement of semen parameters is still controversial. The purpose of this study was to determine the effect of age on semen parameters following varicocelectomy in a group of infertile men. METHODS: Improvements in sperm count, morphology, and motility were studied in 67 infertile patients 4-10 months after varicocelectomy. RESULTS: The mean age of the patients was 30.48 ± 7.49 years. Significant improvements in total sperm count, percentage normal morphology, and motility were noted in all age groups (P < 0.05). Patients aged <25 years demonstrated the greatest increase in sperm counts, normal morphology, and motility following varicocelectomy. There was a significant negative correlation between age and sperm count, sperm morphology, and sperm motility (P < 0.05). CONCLUSION: The effect of age on improvement in sperm parameters after varicocelectomy is inconsistent with some reports in the literature, and could be attributable to the duration of infertility prior to surgery; in the long term, varicoceles are known to have deleterious effects on testis biology.

Comparison of intranasal desmopressin and intramuscular tramadol versus pethidine in patients with renal colic.

PURPOSE: To study the safety and efficacy of intranasal desmopressin and intramuscular tramadol versus pethidine for treatment of renal colic. MATERIALS AND METHODS: A total of 90 adult patients who presented with renal colic to the emergency wards were recruited in this study. The patients were randomly assigned to receive 100 mg intramuscular tramadol, 40µ g intranasal desmopressin, or 40µ g intranasal desmopressin plus 100 mg intramuscular tramadol. The severity of the pain was assessed using Visual Analogue Scale. RESULTS: The studied patients consisted of 49 men and 41 women with the mean age of 35.20 ± 13.26 years (range, 16 to 82 years). There was no statistically significant difference regarding the mean age (F [2, 89] = 2.98, P = .056) and gender differences (X2 = 3.3, df = 2, P = .19) in three groups. There was also no statistically significant difference considering pain relief in 3 studied groups (P = .2). CONCLUSION: We concluded that narcotics such as pethidine cannot be replaced by tramadol in patients with renal colic, but tramadol, desmopressin, or both in combination can reduce pethidine requirement.

Family history and age at the onset of upper urinary tract calculi.

INTRODUCTION: The aim of this study was to evaluate the effect of family history on the age of urinary calculus formation and its relation with characteristics of the calculi and patients. MATERIALS AND METHODS: In a cross-sectional study in Tabriz, a total of 210 patients with upper urinary tract calculi were evaluated. Their demographics and clinical characteristics and detailed information on their family history were recorded. RESULTS: Of the patients, 28.6% had a positive family history for urinary calculi. Siblings were the majority of the affected family members (71.1%). The rate of a positive family history was slightly higher in women than in men (30.0% versus 28.1%; P = .20). The mean age at the disease onset of the men with and without a positive family history was 37.2 years versus 39.3 years, respectively (P = .20). Such a difference was not detected in the female patients, either (P = .63). In general, the calculi were more detected on the left renal unit, but more prevalent on the right side in patients with a positive family history (P = .008). No relation was found between the number and size of the calculi and the family history. CONCLUSION: About one-third of the patients with urinary calculi had a positive family history too. Men with affected family members are slightly more susceptible to the disease at younger ages. There might be differences in the side of the calculi and family members with a history of disease that warrants further studies.

Asymptomatic bacteriuria in pregnant women.

INTRODUCTION: The aim of this study was to evaluate the frequency of bacteriuria in pregnant women referred to the medical centers of Tabriz, Iran, for prenatal care. MATERIALS AND METHODS: A total of 1100 healthy pregnant women who were referred to 50 medical centers in Tabriz for a regular prenatal care were evaluated for bacteriuria. RESULTS: The frequency of asymptomatic bacteriuria was 6.1%. Maternal age was lower in the women with a positive urine culture (P=.02). Asymptomatic bacteriuria had no relationship with gestational age, parity, level of education, and body mass index. CONCLUSION: We found a relatively high rate of bacteriuria in our cohort of asymptomatic pregnant subjects, especially the younger ones. For prevention from the complications of the asymptomatic bacteriuria in pregnant women, such as pyelonephritis, hypertension, preeclampsia, low birth weight, prematurity, septicemia, and even maternal and neonatal death, it is recommended to perform urine culture as a routine evaluation during the pregnancy.