A Multicenter Retrospective Cohort Study of the Profile of Seminal Fluid Analyses of Men Seeking Fertility Care at Different Hospitals.

BACKGROUND: Male infertility contributes 40 % of couple infertility. The prevalence of abnormal semen parameters has been on the increase. Age among other factors affects the fertility potential of males. This study analysed the pattern of seminal fluid parameters of males, seeking fertility treatment in hospitals and the relationship between age, volume and liquefaction time on these other semen parameters. METHODS: This is a multicentre retrospective cohort study conducted in eight secondary and tertiary hospitals in Nigeria. The case notes of couples that sort fertility care at the Gynaecology and Urology clinics of these hospitals from January 1st 2022 to December 31st 2022 were retrieved after receiving ethical approval. A purposeddesigned proforma based on the WHO manual for the examination of human semen was used for data collection. Outcome measures were time of semen collection and examination, volume of semen, sperm number, sperm concentration, PH, agglutination, liquefaction, motility,morphology, vitality, and white blood cell count. Data was analysed using SPSS version 23. Data were presented as means and proportions. P-value of < 0.05 was used as the level of significance. RESULTS: Overall, 1063 couples attended gynaecology and urology clinics with fertility-related concerns within the study period with a retrieval rate of 98.3%. The mean age of participants was 38.24 ± 8 years, while the mean semen volume and sperm concentrations were 2.62 ± 1.6 mls and 34.32 ± 7.4 million respectively. The age of participants significantly affected motility, volume and morphology (p-values of 0.001, 0.001 and 0.004 respectively). The total motility and sperm concentration have an inverse relationship with the age of the participants. CONCLUSION: This study shows that sperm motility decreases with the age of participants. It was also observed that the most common combined abnormality was oligoasthenozoospermia.

CONTEXTE: L'infertilité masculine représente 40 % de l'infertilité des couples. La prévalence des paramètres anormaux du sperme est en augmentation. L'âge, entre autres facteurs, affecte le potentiel de fertilité des hommes. Cette étude a analysé le profil des paramètres du liquide séminal des hommes cherchant un traitement de fertilité dans les hôpitaux et la relation entre l'âge, le volume et le temps de liquéfaction sur ces autres paramètres du sperme. MÉTHODES: Il s'agit d'une étude de cohorte rétrospective multicentrique menée dans huit hôpitaux secondaires et tertiaires au Nigeria. Les notes de cas des couples qui ont eu recours à des soins de fertilité dans les cliniques de gynécologie et d'urologie de ces hôpitaux entre le 1er janvier et le 31 décembre 2022 ont été récupérées après avoir reçu une approbation éthique. Un proforma conçu à dessein et basé sur le manuel de l'OMS pour l'examen du sperme humain a été utilisé pour la collecte des données. Les mesures des résultats étaient le temps de collecte et d'examen du sperme, le volume de sperme, le nombre de spermatozoïdes, la concentration en spermatozoïdes, le PH, l'agglutination, la liquéfaction, la motilité, la morphologie, la vitalité et la numération des globules blancs. Les données ont été analysées à l'aide de SPSS version 23. Les données ont été présentées sous forme de moyennes et de proportions. Une valeur P < 0,05 a été utilisée comme niveau de signification. RÉSULTATS: Dans l'ensemble, 1 063 couples ont fréquenté les cliniques de gynécologie et d'urologie pour des problèmes de fertilité au cours de la période d'étude, avec un taux de récupération de 98,3 %. L'âge moyen des participants était de 38,24 ± 8 ans, tandis que le volume moyen de sperme et les concentrations de spermatozoïdes étaient respectivement de 2,62 ± 1,6 ml et 34,32 ±7,4 millions. L'âge des participants a affecté de manière significative la motilité, le volume et la morphologie (valeurs p de 0,001, 0,001 et 0,004 respectivement). La motilité totale et la concentration en spermatozoïdes ont une relation inverse avec l'âge des participants. CONCLUSION: Cette étude montre que la mobilité des spermatozoïdes diminue avec l'âge des participants. Il a également été observé que l'anomalie combinée la plus fréquente était l'oligoasthénozoospermie. Mots-clés: Infertilité Masculine, Anomalies du Liquide séminal, Nigeria.

Rat liver and kidney post-mitochondrial dysfunction by addition of chronic mixed metal intoxication and hepatorenal wellness mediated by phenolic components from Croton zambiscus leaves.

Chronic exposure of mixed-metal intoxication has been associated with prolonged oxidative stress and severe hepatorenal damage. This present study demonstrates the hepatoprotective and renoprotective activity of Croton zambesicus (C-ZAMB) leaves, naturally occurring phenolic compounds against chronic mixed-metal (EOMABRSL) induced toxicity. 0.5 ml of EOMABRSL via oral route induced chronic hepatoxicity and nephrotoxicity on exposure for 98 days (non-withdrawal) and 70 days (withdrawal) by abnormal alteration in the levels of endogenous antioxidants. Moreover, EOMABRSL induced hepatorenal damage by increasing the markers of liver toxicity (ALT, AST, ALP, GGT and bilirubin) and kidney failure (creatinine, urea, uric acid, and renal electrolytes-Na+ and K+). Both non-withdrawal and withdrawal approaches of EOMABRSL-exposed animals exhibited hepatorenal dysfunctions by increasing the activity of eco-51-nucleotidase (51ENT) followed by the decreased in the activity of lactate dehydrogenase (LDH)-index of cellular ATP. These results were further supported by the histopathological examination of nephritic cells, hepatocytes and splenocytes, manifested by hepatocellular necrosis, swelling or degeneration of tubular kidney epithelial cells as well as coalescing splenic periarteriolar lymphoid sheaths (PALSs) and lymphoid haemosiderin. The chronic EOMABRSL intoxication was ameliorated by administration of phenolic antioxidants from C-ZAMB leaves. Therefore, our study supports the view that phenolic C-ZAMB leaves may mediate hepatorenal wellness on chronic exposure to mixed-metal intoxication.

The microsurgical anatomy of the jugular foramen.

The microsurgical anatomy of the jugular foramen was studied in 10 fixed cadavers, each cadaver consisting of the whole head and neck. Five of the cadavers were injected with latex. The jugular foraminal region was exposed using the infratemporal fossa type A approach of Fisch and Pillsbury in five cadavers (10 sides) and the combined cervical dissection-mastoidectomy-suboccipital craniectomy approach in five cadavers (10 sides). The right foramen was larger than the left in seven cases (70%), equal in two cases (20%), and smaller in one case (10%). The dura covering the intracranial portal of the foramen had two perforations, a smaller anteromedial perforation through which passed the ninth cranial nerve (CN IX), and a larger posterolateral perforation, through which passed the 10th and 11th cranial nerves (CNs X and XI) and the distal sigmoid sinus. The perforations were separated by a fibrous septum in 16 specimens (80%). After exiting the posterior fossa, CNs IX, X, and XI all lay anteromedial to the superior jugular bulb (SJB) within the jugular foramen. The inferior petrosal sinus (IPS) entered the foramen between CNs IX and X in most cases; however, in 10% of our cases it entered the foramen between CNs X and XI, and in 10% it entered the foramen caudal to CN XI. The IPS terminated in the SJB in 90% of our cases; in 40%, the IPS termination consisted of multiple channels draining into both the SJB and internal jugular vein. This study shows that the arrangement of the neurovascular structures within the jugular foramen does not conform to the hitherto widely accepted notion of discrete compartmentalization into an anteromedial pars nervosa containing CN IX and the IPS and a posterolateral pars venosa containing the SJB, CNs X and XI, and the posterior meningeal artery.