Frequency of Y chromosome microdeletions and chromosomal abnormalities in infertile Thai men with oligozoospermia and azoospermia

Aim： To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods： From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction （PCR） using 11 gene-specific primers that covered all three regions of the azoospermic factor （AZFa, AZFb and AZFc）. Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL） and testosterone were measured by electrochemiluminescence immunoassays （ECLIA）. Results： Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region （50%）, followed by AZFb （33%） and AZFbc （17%）. No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions. Conclusion： The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.

Hepatitis B and C virus co-infections in human immunodeficiency virus positive North Indian patients

AIM: To determine the prevalence of hepatitis B and C virus infections in human immunodeficiency virus (HIV) -positive patients at a tertiary care hospital in New Delhi, India. METHODS: Serum samples from 451 HIV positive patients were analyzed for HBsAg and HCV antibodies during three years (Jan 2003-Dec 2005). The control group comprised of apparently healthy bone-marrow and renal donors. RESULTS: The study population comprised essentially of heterosexually transmitted HIV infection. The prevalence rate of HBsAg in this population was 5.3% as compared to 1.4% in apparently healthy donors (P < 0.001). Though prevalence of HCV co-infection (2.43%) was lower than HBV in this group of HIV positive patients, the prevalence was significantly higher (P < 0.05) than controls (0.7%). Triple infection of HIV, HBV and HCV was not detected in any patient. CONCLUSION: Our study shows a significantly high prevalence of hepatitis virus infections in HIV infected patients. Hepatitis viruses in HIV may lead to faster progression to liver cirrhosis and a higher risk of antiretroviral therapy induced hepatotoxicity. Therefore, it would be advisable to detect hepatitis virus co- infections in these patients at the earliest.

Predictive modeling in neurocritical care using causal artificial intelligence

Artificial intelligence(AI)and digital twin models of various systems have long been used in industry to test products quickly and efficiently.Use of digital twins in clinical medicine caught attention with the development of Archimedes,an AI model of diabetes,in 2003.More recently,AI models have been applied to the fields of cardiology,endocrinology,and undergraduate medical education.The use of digital twins and AI thus far has focused mainly on chronic disease management,their application in the field of critical care medicine remains much less explored.In neurocritical care,current AI technology focuses on interpreting electroencephalography,monitoring intracranial pressure,and prognosticating outcomes.AI models have been developed to interpret electroencephalograms by helping to annotate the tracings,detecting seizures,and identifying brain activation in unresponsive patients.In this mini-review we describe the challenges and opportunities in building an actionable AI model pertinent to neurocritical care that can be used to educate the newer generation of clinicians and augment clinical decision making.

Social and gender biases in HIV /AIDS care in India

To understand the socio-psychological aspects of HIV transmission and gender and caste based AIDS care in India, 100 HIV positive patients and their spouses or sexual partners were included in this study.The individuals were interviewed for their pre-or extramarital sexual exposure with suspected HIV positive persons.They were also interviewed about the barriers,if any,they used,and change in their sexual behaviour with their spouses after they were tested HIV positive.All except three were males who were first detected HIV positive,while 3 women were found HIV positive first and subsequendy dieir male partners were included in the study.Eighty of 97(82.4%) males admittedly acquired HIV through heterosexual route.Of the 80 males,60(75%) acquired HIV infection from organised CSWs and 20 from casual sex partners.Many of these acquired the infection just before their marriages.More than half of these males were infected during only one or two sexual encounters. Sixty out of 75(80%) married males continued to have sex even after knowing their HIV positive status.One male and six female spouses did not get infected even after multiple insertive unprotected sex.The average life span after the diagnosis of HIV infection in Indian males without specific treatment was 4.5±3. 5 yr while in women it was 3.5±2.0 yr,indicating fast progression of AIDS in females,most probably due to gender bias in access to treatment,nutrition,care and also due to hormonal differences.Pulmonary tuberculosis was most common and first clinical presentation of HIV associated opportunistic infection.The study also showed that due to ignorance majority of husbands do not share their HIV positive status with their wives and continue to have unsafe sex.

Telavancin in Experimental Murine Pneumococcal Pneumonia

We determined whether telavancin is as active in experimental immunocompetent murine pneumococcal pneumonia as is vancomycin or ceftriaxone. Experimental murine pneumonia was established by intratracheal administration of Streptococcus pneumoniae. Four groups of animals were studied, untreated and treated with vancomycin (110 mg/kg, bid, SQ), telavancin (40 mg/kg, bid, SQ), or ceftriaxone (50 mg/kg, bid, SQ) for 2 days. The untreated animals had a mean of 6.54 ± 0.82 log10 cfu/g lung. The vancomycin-, telavancin-, and ceftriaxone-treated animals had means of 2.01 ± 0.02, 2.00 ± 0.00, and 2.00 ± 0.01 log10 cfu/g lung, respectively (p-values < 0.0001 for each treatment group versus the untreated group). In the model studied, telavancin was as active as vancomycin and ceftriaxone in treating experimental pneumococcal pneumonia in mice.

Bridging the divide: Harmonizing polarized clinical laboratory medicine practices

In today's healthcare,clinical laboratory medicine stands as a cornerstone of patient care,providing vital diagnostic insights that inform decisions in disease management.Yet,within this crucial field,a dichotomy persists between two predominant models of laboratory testing to support clinical practice:point-of-care testing(PoCT)and central laboratory testing[1].This schism,while born of practical necessity and evolving technology,presents both opportunities and challenges that warrant closer examination.