Association of occupational exposure on semen density in male industrial workers undergoing infertility treatment at tertiary care hospital

Background: Working with particular substances or under certain working situations may cause some workers to experience abnormalities in their sexual or reproductive health. Occupational exposures can lead to infertility, but the workers may not be aware of such problems. The purpose of the study was to determine the association between male infertility and occupation of industrial workers in organized sector.Methods: Prospective case-controlled study that included 136 industrial workers working in organized sector and attending infertility clinic for treatment. This study included male partners aged between 21-46 years with primary or secondary infertility and undertaking same occupation for at least last three months. Complete infertility workup of all male partners attending infertility clinic was done that included detailed history and information related to occupation. Routine semen parameters were evaluated according to the 2010 World Health Organization (WHO) criteria.Results: In the present study, significant semen abnormalities were observed in male partners with age more than 31 years and undertaking arduous jobs for more than 5 years (p <0.05) in study group (n=136) as compared to control group (n=62). The abnormal semen count were observed in 114 (83.2%) workers in the study group that included 43 (31.6%) with total sperm concentration (TSC) less than 10 million/ml and azoospermia in 44 (32.3%). Reduced motility (asthenozoo-spermia) was observed in majority 125 (91.9%) of male partners. The findings were significant (p <0.05) as compared to control group.Conclusions: Preventive measures in the workplace need to be established to reduce the effect of occupational hazards and its influence in the semen parameters ultimately leading to infertility.

Prediction of mortality and morbidity by simplified acute physiology score II in obstetric intensive care unit admissions.

BACKGROUND: Critical care in obstetrics has received much attention in recent times. Despite progress in medical field and improvement in health facilities provided, maternal mortality is still very high in most of the developing countries. AIM: To study and analyze records of patients requiring intensive care in obstetrics and to assess utility of simplified acute physiology score (SAPS II) for predicting maternal mortality. SETTING: A multidisciplinary intensive care unit (ICU) at a tertiary care center. DESIGN: Retrospective review. MATERIALS AND METHODS: Fifty-seven consecutive obstetric patients' records requiring ICU admissions were studied for clinical picture, diagnosis, complications, morbidity and mortality over a period of 21/2 years - from 1st May 2002 to 31st Oct. 2004. SAPS II score was calculated according to the different variables for predicting mortality. STATISTICAL ANALYSIS: SAPS II scores were regressed on mortality status using logistic regression analysis. The predictability was assessed by goodness-of-fit test and receiver operated characteristic curve. RESULTS: Maternal mortality in obstetric ICU admissions was 1.15/1,000 deliveries, amounting to 40.35% of obstetric ICU admissions. The mean SAP II score was significantly higher (40.04 +/- 12.97 vs. 22.6 +/- 7.31) in those patients who died compared to survivors (P < 0.001%). CONCLUSIONS: The SAPS II accurately predicted mortality in obstetric patients admitted to ICU. Computation of the score as a routine in ICU may help in identifying those at high risk of mortality and then to reduce this risk.

Severity, affect, family and environment (SAFE) approach to evaluate chronic pelvic pain in adolescent girls.

BACKGROUND: Pelvic pain is common in adolescent girls in day-to-day practice. Severity, Affect, Family and Environment (SAFE) is a recent interview strategy to approach these patients and their families. AIM: 1. To find the prevalence of pelvic pain in adolescent girls. 2. To find out the feasibility and acceptability of "SAFE" approach in evaluating chronic pelvic pain in adolescent girls. SETTINGS & DESIGN: 200 adolescent girls aged 13-23 years were selected at random from school and colleges nearby hospital campus. METHOD: A questionnaire method was adopted. Adolescent girls selected were divided into two groups, group I (with pain) and group II (without pain). STATISTICAL ANALYSIS: It was performed using chi-square and Fischer tests with significance of p value being taken at 0.05. RESULTS: Out of 200 adolescent girls selected for interview, prevalence of pelvic pain was found to be 37.0%. Dysmenorrhoea was also found to have significant relationship with pelvic pain. Depression and anxiety, school absences and loss of weight were found to have significant association with pain. Pelvic pain was found to be more in adolescent girls with large family size (> 4 members), single parent, both parents working, ongoing marital problems at home and was less reported when there was good parent-child communication about sex and when the teenager was well prepared for menarche by the parents and the association with the above mentioned factors was found to be significant. CONCLUSION: "SAFE" approach contributes in identifying health problems in adolescent girls with chronic pelvic pain.

Mini laparotomy versus conventional laparotomy for abdominal hysterectomy: a comparative study.

BACKGROUND: Less traumatizing measures for hysterectomies are searched for to improve the recovery from surgery. AIM: Comparison of minilaparotomy abdominal hysterectomy with conventional abdominal hysterectomy in respect to per-operative and post-operative outcome and complications. SETTING AND DESIGN: In a medical college hospital patients undergoing abdominal hysterectomy were enrolled. It was a concomitant comparative study. METHODS AND MATERIAL: We are presenting our comparative data of 100 cases of minilaparotomy abdominal hysterectomy (group I, incision =< 6 cm) performed over last 4 years from January 1998 to December 2002 and comparing the outcome with 99 cases of abdominal hysterectomy (group II, incision > 6 cm) done by traditional method over the same duration. STATISTICAL ANALYSIS USED: Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student's t test was used for continuous data. RESULTS: Mean age and parity of patients were similar in the two groups. Incision was transverse in 100% cases in-group I and 22.2% cases in-group II. Estimated blood loss was significantly higher (354 ml) in group II in contrast to group I (240 ml). Blood transfusion was also required more commonly (22.2%) in-group II than in-group I (9%). Mean operative time was significantly more in-group II (90 minutes) than in group I (41 minutes). Mean hospital stay, day of mobility, starting oral diet and days of injectable analgesics required were higher in group II than in group I. Major complications were rare in both the groups, but minor complications were significantly higher in group II (40.4%) than in group I (26%). CONCLUSION: Minilaparotomy abdominal hysterectomy appears to be an attractive alternative to traditional abdominal hysterectomy with fewer complications.