Formalin toxicity in hydatid liver disease

Two cases of formalin toxicity developed within 5 to 10 minutes of the placement of packs soaked in formalin within hepatic hydatid cysts. Hypotension, severe tachycardia, postoperative anuria, tachypnoea, restlessness, unconsciousness and coma developed. There was no response to the treatment given. Treatment was continued for about 12 hours. The problems associated with the use of formalin are discussed.     

High prevalence of vitamin D deficiency in north Indian adults is exacerbated in those with chronic kidney disease

Aim:   Vitamin D is being increasingly recognized as an important player in disease. Hypovitaminosis D is widespread in chronic kidney disease (CKD) populations around the world. The vitamin D status of Indian CKD patients is not known.
Methods:   Levels of 25(OH) vitamin D and parathyroid hormone (PTH) were measured in adult north Indian male patients with newly diagnosed stage IV–V CKD and matched control subjects drawn from the same population. A total of 100 (34 stage IV and 66 stage V) patients with CKD and 72 controls were studied.
Results:   Only 4% control and 1% of CKD subjects had normal (>30 ng/mL) vitamin D levels. Approximately 68% of control and 77% of the CKD population had vitamin D deficiency (<15 ng/ml) whereas the remaining 38% control and 22% CKD patients had insufficient (15–30 ng/mL) vitamin D levels. Levels were lower in CKD subjects compared to their family members, and the CKD patients were significantly more likely to have severe vitamin D deficiency (<5 ng/mL). A strong negative correlation was noted between vitamin D and PTH. No significant correlation was found between vitamin D levels and body mass index, bodyfat percentage, serum albumin or calcium levels.
Conclusion:   Vitamin D deficiency is highly prevalent in north Indians, and this is more pronounced in CKD subjects. There is a significant inverse correlation between the vitamin D and PTH levels. The clinical significance of this deficiency and the potential benefits to be derived from vitamin D supplementation in this population merits further studies.     

Effect of tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) on human sperm motility, viability and motion parameters

Male genital tract infections and non-specific inflammatory conditions may be associated with unexplained infertility. Previous studies have shown the presence of cytokines such as tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in the semen of infertile men. However, the mechanism of effect of these cytokines on human sperm function is still controversial. The present study was undertaken to investigate the in-vitro effects of TNF-α and IFN-γ on human sperm motion, viability and the hypoosmotic swelling test (HOST).
Washed spermatozoa from normal volunteers ( n =9) were incubated in the presence/absence of TNF-α (1 μg/mL) plus IFN-γ (0.1 μg/mL). Sperm motility, viability, HOST, and video sequences were recorded at different time intervals (0, 30, 60 and 180 min). Sperm motion parameters were analysed using computer-assisted semen analysis. There was a time-dependent negative effect of TNF-α plus IFN-γ on sperm motility, viability, HOST, and lateral-head displacement (ALH). The maximum decrease was observed between 60 and 180 min for sperm motility (50.8 ± 5.6%), viability (52.8 ± 4.0%), HOST (38 ± 2%) and ALH (4.7 ± 0.1 μm) compared to control samples (62.2 ± 2.8, 62.4 ± 2.9, 58 ± 4, and 5.3 ± 0.4, respectively; All p  < 0.05). There was no significant effect on sperm straight-line velocity and mean linearity when compared to control.
These data suggest that the common inflammatory cytokines TNF-α plus IFN-γ have only partial detrimental effects on sperm motility, viability, membrane integrity and lateral head displacement, which may contribute to the poor fertilizing potential of human spermatozoa during inflammatory conditions.