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Biomedical subjects

A Agarwal

Publications and source records attributed to A Agarwal.

At least 163 records · Page 9Linked to original sources
PubMed2000

The effect of patient and semen characteristics on live birth rates following intrauterine insemination: a retrospective study.

PURPOSE: To identify characteristics of female patients and of semen that were associated with live birth following intrauterine insemination (IUI). METHODS: Retrospective review of medical and laboratory results from 533 women who underwent IUI with partner's sperm from 1993 through 1995. RESULTS: Among 1728 cycles, 116 (6.7%) resulted in live deliveries. Among the 38 patient and semen variables analyzed, only 3 were associated with successful IUI outcome: female age < 37.7 years at the time of treatment (P = 0.02); the absence of any corrective pelvic surgery (P < 0.001); and postwash sperm motility (P = 0.006). Couples with none of these three risk factors achieved per-cycle pregnancy rates of 12.4%. Women with two risk factors (age and pelvic surgery) achieved per-cycle pregnancy rates of 4.6% when sperm had good postwash motility. No pregnancies were achieved when low postwash motility was combined with any other risk factor. CONCLUSIONS: Advanced female age, poor postwash sperm motility, and a history of corrective pelvic surgery are significant risk factors for poor IUI success rates. Poor postwash sperm motility in combination with either of these other two risk factors resulted in no successful pregnancies.

Adult↗
PubMed2000

Effect of clinical and semen characteristics on efficacy of ovulatory stimulation in patients undergoing intrauterine insemination.

PURPOSE: We measured the effect of ovulatory stimulation (OS) upon intrauterine insemination (IUI) success rates, particularly among patients with risk factors for IUI failure. METHODS: Retrospective review of medical and laboratory results from 512 patients who underwent 1576 cycles of IUI with partner's sperm over a 3 year period. Data were collected on 3 risk factors for IUI failure (advanced female age > 37.7 years, prior corrective pelvic surgery, and poor post-wash sperm motility), and on method of OS (none, clomiphene citrate, or gonadotropin). RESULTS: Patients who underwent OS had significantly higher pregnancy rates (7.6%) than those who did not (4.7%, p = 0.02). However, when patients were stratified by their risk factors, OS made a significant difference only for patients without risk factors. These patients had a 15.5% per cycle pregnancy rate with OS, compared to 7.9% in unstimulated IUI cycles (p = 0.04). CONCLUSIONS: Ovulatory stimulation doubles IUI pregnancy rates among young patients without a prior pelvic surgery and with good post-wash semen quality. The benefit of OS for patients with risk factors for IUI failure is unclear. These patients should be counseled that their chances for success with IUI are limited, with or without OS.

Adult↗
PubMed2000

The effects of cryopreservation on semen from men with sarcoma or carcinoma.

PURPOSE: This study evaluated prefreeze and postthaw semen quality before treatment in patients with different types of sarcomas and carcinomas to determine whether cryopreservation would be of value for these patients. METHODS: Semen specimens were obtained from 50 normal donors and from 21 patients with carcinoma and from 14 patients with sarcoma. The specimens were cryopreserved by a standard freezing procedure using TEST-Yolk buffer. Prefreeze and postthaw sperm motion characteristics were measured. RESULTS: Prefreeze total motile sperm count was significantly higher in donors (median: 129.6 x 10(6)/ml) than in men with carcinoma (46.9 x 10(6)/ml, P < .001) or sarcoma (66.3 10(6)/ml, P = .04). The percent motility and percent linearity were significantly lower in patients with carcinoma. In postthaw specimens, total motile sperm count, curvilinear velocity, and linearity were significantly lower in patients with carcinoma. CONCLUSIONS: The two patient groups in this study had poor semen quality when compared with healthy donors both before and after cryopreservation. Sarcoma patients had better semen quality than carcinoma patients. As cancer therapy in these men could significantly impair their reproductive potential, these men should be advised to preserve their semen before starting treatment.

Adult↗
PubMed2000

Role of hepatitis E and other hepatotropic virus in aetiology of sporadic acute viral hepatitis: a hospital based study from urban Delhi.

Major hepatotropic virus continues to be an important cause of acute viral hepatitis (AVH) in developing countries like India. While epidemics of AVH have been well studied few serious sporadic cases from developing countries have been reviewed. We studied prospectively 75 cases of sporadic AVH who reported to our hospital and were evaluated for the presence of various hepatotropic viruses. The seroprevalence of IgG anti-HEV antibodies was studied in the general population as a control. We found 53.3% (40/75) of sporadic AVH cases were due to hepatitis E virus while 11% (8/75) were due to hepatitis B virus. Hepatitis C virus was responsible for 8% (6/75) of the sporadic AVH cases and hepatitis A was found in 5% (4/75) of the cases. No causative agent was found in 23% (17/75) of the sporadic AVH cases. The sporadic AVH cases due to HEV were not clinically or biochemically not different from AVH due to other viruses. We found a high prevalence of IgG anti-HEV in 35.6% (178/500) among the general population of urban Delhi. The study suggested that hepatitis E was the most common cause of sporadic AVH in urban Delhi. High seroprevalence of IgG anti-HEV antibodies in the general population and amongst the sporadic AVH cases suggests that it is unlikely to be protective antibody. IgM anti-HEV positive serology is considered diagnostic of acute hepatitis E infection in India, where hepatitis E is endemic.

Acute Disease↗
PubMed2000

Characteristics of cryopreserved semen from men with lymphoma.

PURPOSE: This study compared the pretreatment semen quality in patients with Hodgkin's disease and non-Hodgkin's lymphoma with a group of healthy donors. We also examined the differences in prefreeze and postthaw semen quality among the different stages of Hodgkin's disease. METHODS: The study included 89 patients with Hodgkin's disease, 18 with non-Hodgkin's lymphoma, and 50 healthy sperm donors. RESULTS: In patients with Hodgkin's disease, the prefreeze and postthaw semen characteristics were significantly lower than those of the healthy donors. Similar results also were seen in patients with non-Hodgkin's lymphoma. No significant differences in the prefreeze semen quality were seen in patients with different stages of cancer. CONCLUSION: Patients with Hodgkin's disease and non-Hodgkin's lymphoma in our study had poor semen quality when compared with healthy donors both before and after cryopreservation. As cancer therapy significantly impairs reproductive potential, sperm banking should be offered to these men before the start of their therapy.

Adult↗
PubMed2000

Semen banking in patients with cancer: 20-year experience.

Modern techniques of banking sperm provide an effective way to preserve the option of future fertility for most teenagers and young men diagnosed with a variety of malignancies that will necessitate treatment with chemotherapy, pelvic surgery, or significant radiation doses to the testes. Results of cumulative data collected at the Cleveland Clinic Foundation from patients with testicular cancer, lymphoma, leukemia, sarcoma, carcinoma and other kinds of malignancy have revealed that: (1) pretreatment semen quality (pre-freeze and post-thaw) in patients with cancer is poorer compared with healthy donors; (2) the percentage decline in semen quality (from pre-freeze to post-thaw) in patients with cancer is similar to that of normal donors. This suggested that the effect of cryodamage on spermatozoa from patients with cancer is similar to that of normal donors. (3) The stage of cancer in patients with testicular cancer and Hodgkin's disease shows no relationship to their semen quality. Based on studies conducted at the Cleveland Clinic Foundation, we recommend that sperm cryopreservation be offered to all men of reproductive age who have malignancies. Cryopreservation is safe and inexpensive, and gives patients a chance to establish pregnancies in the future with an assisted reproductive technique.

Feasibility Studies↗
PubMed2000

Improvement in motion characteristics and acrosome status in cryopreserved human spermatozoa by swim-up processing before freezing.

The purpose of this study was to examine if selecting a sperm population with improved motion characteristics before freezing reduces the deleterious effects of cryopreservation. Semen specimens from 15 normal donors were divided into two equal aliquots. The first aliquot received no treatment (control), and the second was processed by swim-up from a washed sperm preparation to select a sperm population with better motility and motion characteristics (swim-up). Both aliquots were cryopreserved by the liquid nitrogen vapour method. Percentage motility and motion characteristics were evaluated by computer-assisted semen analysis. Acrosome integrity as well as spontaneous and calcium ionophore-induced acrosome reactions before freezing and after thawing were assessed by fluorescein isothiocyanate conjugated peanut agglutinin combined with a supra vital dye (Hoechst-33258). Swim-up processing enabled selection of a sperm population with better motion characteristics, percentage motility and viability before freezing (P < 0.001), but with no difference in percentage of acrosome-intact spermatozoa (P = 0.63). After thawing, the swim-up specimens exhibited faster velocity and progression than untreated specimens (P < 0.001). They also had higher percentages of spermatozoa with intact acrosomes and spermatozoa able to undergo acrosome reaction in response to calcium ionophore (P < 0.05). Selecting a highly motile sperm population before freezing enhances overall post-thaw spermatozoa quality.

Acrosome Reaction↗
PubMed2000

Quantitative TEM of point defects in Si

We review the use of transmission electron microscopy (TEM) to provide a quantitative measurement of both vacancy and interstitial clusters in ion-implanted silicon. Interstitials agglomerate into rod-like defects on 131I) planes, and the evaporation of these defects can be directly correlated to the diffusion enhancements observed during annealing of ion-damaged silicon. Vacancy clusters are easily detected in TEM once they have been labelled using a Au-diffusion technique. The combination of the two approaches provides a quantitative test for models of implantation and annealing in silicon. Detailed models for point defect behaviour, which include Ostwald-ripening and the surface recombination velocity, reproduce all of the crucial features of the observed defect annealing.

Journal Article↗
PubMed2000

Heme oxygenase-1 gene ablation or expression modulates cisplatin-induced renal tubular apoptosis.

Heme oxygenase-1 (HO-1) is a 32-kDa microsomal enzyme that catalyzes the conversion of heme to biliverdin, releasing iron and carbon monoxide. Induction of HO-1 occurs as a protective response in cells/tissues exposed to a wide variety of oxidant stimuli. The chemotherapeutic effects of cis-diamminedichloroplatinum(II) (cisplatin), a commonly used anticancer drug, are limited by significant nephrotoxicity, which is characterized by varying degrees of renal tubular apoptosis and necrosis. The purpose of this study was to evaluate the functional significance of HO-1 expression in cisplatin-induced renal injury. Our studies demonstrate that transgenic mice deficient in HO-1 (-/-), develop more severe renal failure and have significantly greater renal injury compared with wild-type (+/+) mice treated with cisplatin. In vitro studies in human renal proximal tubule cells demonstrate that hemin, an inducer of HO-1, significantly attenuated cisplatin-induced apoptosis and necrosis, whereas inhibition of HO-1 enzyme activity reversed the cytoprotective effect. Overexpression of HO-1 resulted in a significant reduction in cisplatin-induced cytotoxicity. These studies provide a basis for future studies using targeted gene expression of HO-1 as a therapeutic and preventive modality in high-risk settings of acute renal failure.

Acute Kidney Injury↗
PubMed2000

Toxicity of ingested formalin and its management.

Formaldehyde is a physiological intermediary metabolite taking part in many biological process in the body. It is a constituent of many items of daily use, including foods. It is also used in medicine for treatment of some conditions. A 40% solution of formaldehyde in water is known as formalin. Formalin is irritating, corrosive and toxic and absorbed from all surfaces of the body. Ingestion is rare because of alarming odour and irritant effect but documented in accidental, homicidal or suicidal attempts. Ingestion can lead to immediate deleterious effects on almost all systems of the body including gastrointestinal tract, central nervous system, cardiovascular system and hepato-renal system, causing gastrointestinal hemorrhage, cardiovascular collapse, unconsciousness or convulsions, severe metabolic acidosis and acute respiratory distress syndrome. No specific antidote is available. Treatment of toxicity is supportive care of the various organ systems. Multidisciplinary approach is required for proper management.

Administration, Oral↗
PubMed2000

Association of ureaplasma urealyticum with abnormal reactive oxygen species levels and absence of leukocytospermia.

PURPOSE: Ureaplasma urealyticum is a commensal of the lower genitourinary tract of many sexually active adults. The organism is more common in partners of infertile than fertile marriages. We conducted a prospective study at our tertiary care center to confirm a possible association between U. urealyticum and abnormal sperm function parameters. MATERIALS AND METHODS: A total of 50 consecutive male patients seeking general urology consultation for lower urinary tract symptoms characteristic of chronic prostatitis were evaluated. Urine and semen localization cultures were performed with additional semen cultures for U. urealyticum, Chlamydia trachomatis and Mycoplasma hominis. Specimens from 21 healthy men were used as controls. Specimens were analyzed by a computer assisted semen analyzer, and verified manually for concentration, percent motility and morphology. Leukocytospermia was measured by the Endtz test. Semen specimens were also analyzed for reactive oxygen species (ROS), acrosome reaction and mannose binding assay. RESULTS: Of the patients 17 had positive U. urealyticum cultures and the other cultures were negative. Patients with U. urealyticum had significantly higher ROS levels (log [ROS + 1] = 2.52 +/- 0.25) than those without U. urealyticum (1.49 +/- 0.20, p = 0.002) or controls (1.31 +/- 0.19, p = 0.002). Leukocytospermia was detected in only 1 of the 17 (6%) positive specimens and 4 (12%) negative specimens. CONCLUSIONS: Seminal ROS levels are elevated among patients with U. urealyticum. ROS induces lipid peroxidation, which reduces membrane fluidity and sperm fertilization capability, and may be the mechanism by which U. urealyticum impairs sperm function. Absence of leukocytospermia does not exclude U. urealyticum.

Adult↗
PubMed2000

Impact of the integrated child development services (ICDS) on maternal nutrition and birth weight in rural Varanasi.

OBJECTIVE: To evaluate the impact of ICDS on maternal nutrition and birth weight. SETTING: 28 ICDS and 21 non-ICDS villages in two adjoining blocks of Varanasi. METHODS: 5289 pregnancies were registered during 1987-1993 in these two blocks. In the ICDS block 916 and 1453 nutrition supplemented and unsupplemented, respectively and 1748 of the non-ICDS live births with weight recorded within 48 h formed the study subjects. RESULTS: The ICDS supplemented mothers gained 100g more in pregnancy and birth weight was higher by 58 g (p < 0.05) as compared to unsupplemented ICDS mothers. Birth weight in unsupplemented ICDS areas was 25g higher as compared to non ICDS area. ICDS supplemented women had a significantly smaller proportion of low birth weight babies (14.4%) compared to ICDS unsupplemented (20.4%) and non-ICDS women (26.3%). The corresponding prevalence of preterm births was 2.0, 2.4 and 4.3%, respectively (P < 0.001). Multiple regression analysis showed that increased wight gain in pregnancy, length of gestation, caloric intake and term hemoglobin were significantly associated with birth weight. However, the length of gestation was not influenced by factors improving the birth weight. CONCLUSION: Undernourished pregnant women are benefitted by late pregnancy nutrition supplement

Adult↗
PubMed2000

A study of myasthenia gravis in patients with and without thymoma.

This study was undertaken to compare the clinical, neurophysiological, radiological and prognostic features of myasthenia gravis with and without thymoma. 37 patients with myasthenia gravis (27 males, 10 females), with age range of 4.5 to 72 (mean 39) years, were managed at a tertiary care centre in India. Four patients were below 15 years of age and 6 above 55 years. Most of the patients were in stage II (34). There were 2 patients in stage III and 1 in stage I. 27 patients underwent thymectomy. Thymoma was detected in 10 cases. The decrement in patients with thymoma ranged between 11 and 62% (mean 27.9%) and nonthymoma group 10-75% (mean 28%). CT scan of thorax revealed mediastinal mass in 5 out of 10 cases of thymoma and 2 out of 27 patients without thymoma. Outcome of myasthenia gravis with thymoma was worse than without thymoma at 1 year followup. Severity of illness, extent of decrement, lack of facilitation, duration of illness and age of the patients were not related to the outcome. It is concluded the clinical and neurophysiological changes in myasthenia gravis with and without thymoma do not differ. However, patients with thymoma have a worse outcome.

Adult↗