Suliman H. Al-Fifi

Impact of Male Obesity on Semen Quality and Serum Sex Hormones

Introduction. To investigate the association of high Body Mass Index (BMI) with semen parameters and reproductive hormones in men of reproductive age. Setting. The Saudi Center for Assisted Reproduction. Method. This study was conducted during the period from February 2009 to February 2011. Subjects were exposed through medical history evaluation as well as physical examination. BMI was calculated. Two semen samples about 1 week apart were taken from each participant by masturbation after 2–5 days of abstinence. The samples were assessed according to the WHO Criteria. Blood samples (5 ml) were withdrawn; centrifuged and the resulting sera were preserved at −4 degrees Centigrade. Serum FSH, LH, PRL, and Testosterone levels were estimated by the ELISA method. Results. There was no significant correlation between BMI and any of semen and hormonal parameters. There was significant negative correlation between age and total motility. Only the advanced paternal age has shown significant association with low motility (P = 0.007). Conclusion. Our study showed a significant effect of aging on sperm motility and concentration.

Congenital anomalies and other perinatal outcomes in ICSI vs. naturally conceived pregnancies: a comparative study

BackgroundIntracytoplasmic sperm injection (ICSI) procedures have become accepted worldwide and their effect on society is well-known. However, the full extent of the possible complications of these procedures on maternal and neonatal outcome is still unclear.Materials and MethodsThis is a retrospective case controlled study from January 2003 to December 2007 which compared 253 women that had conceived using assisted reproduction (ICSI) and delivered 327 children at our center (study group) with a matched group of 349 women who naturally conceived and delivered 354 children at Abha General Hospital (control group) during the same period. The obstetrical and neonatal characteristics of the women and their children were assessed to determine any significant differences between the groups.ResultsThe number of gestations per pregnancy (1.34 ± 0.57 vs. 1.01 ± 0.12) and number of children born per woman (1.28 ± 0.49 vs. 1.01 ± 0.12) was significantly higher in the ICSI group (p < 0.001). In addition, the gestational age at delivery (37.23 ± 2.68 vs. 38.56 ± 1.89) was significantly shorter in the ICSI group (p < 0.001) and this led to an increased number of obstetrical interventions, as well as the incidence of cesarean deliveries. Examination of the new-born children revealed similar incidence of congenital anomalies in both groups.ConclusionICSI conceived pregnancies were characterized by an increased number of gestations and live-born, and there was no increase in congenital malformations compared to naturally conceived pregnancies.

Pattern of corrosive ingestion in southwestern Saudi Arabia.

Background/Aims: Ingested corrosive material is a major pediatric emergency all over the world. The corrosive material can cause damage to the digestive tract, ranging from minor injury to strictures, and sometimes even death. We aimed to review the pattern of corrosive ingestion in children who had been admitted to Aseer Central Hospital in the Southwestern region of Saudi Arabia. Methods: This is a retrospective study of all children who had been admitted with a history of corrosive ingestion to Aseer Central Hospital over a period of five years period from 1990 to 1995. The records of 72 patients (38 males and 34 females) were reviewed. The data included age, sex, time lapse till admission, action taken by parents, presenting symptoms, general management given to the child, barium study, endoscopy, and the postcorrosive ingestion outcome of the child. Results: The mean age of the pediatric patients was 28 ± 20 months. Different types of corrosives were encountered. The most common type was 5.25% hypochlorite in 36 patients (50%), kerosene in 12 patients (16.7%), caustic soda in nine patients (12.5%), hydrogen chloride and N-alkyl dimethyl benzyl ammonium chloride (HC and ADB) in eight patients (11.1%), and other material in seven patients (9.7%). Endoscopy was done in 30 patients (31.7%), 14 of whom were abnormal. Barium swallow was performed in 11 patients; five of them showed strictures that required frequent dilatation whereas one needed interposition surgery. Conclusion: Corrosive injury is still a major pediatric emergency among young children. It carries a major risk of complications (mainly stricture) and requires standardized management based on evidence-based medicine.

Drowning in children: Aseer Central Hospital experience, Southwestern Saudi Arabia

Aim: To study the reasons, magnitude and outcome of drowning following submersion in water of children admitted to the Pediatric Intensive Care Unit in Aseer Province, Saudi Arabia. Materials and Methods: A retrospective cohort study of all pediatric patients (0-13) years old who drowned and were admitted to the Pediatric Intensive Care Unit, Aseer Central Hospital, Southwestern Saudi Arabia, between January 1st 1999 and December 31st 2009. Results: A total of 19 cases were admitted following submersion in water. The mean age was 5.2 years ±3.8. Majority of victims (94.1%) were from the highland areas. Events most frequently occurred in the summer (46.7%), followed by spring and winter, 33.3% and 20%, respectively. Home events constituted 44.4% of submersion cases. Of these, 55.6% drowned in a washing container, While 53.4% submersed in swimming pools. Twenty-two percent of these accidents occurred in the sea and in wells while 11.1% occurred in a lake. The mean duration of submersion was 4.04 minutes ± 5.35. Cardiac arrest was reported upon arrival at hospital in 42.1% of the victims. There were seven deaths (36.8 %) and in one patient (5.2 %) there was severe brain injury. In all deceased cases, no adults were watching the children when the accidents occurred. Conclusion: Drowning is a significant risk factor facing our children and can claim lives. The media as well as the authority should play a major role in increasing the public awareness to minimize or prevent such a problem.

The relation of age to the severity of Type I diabetes in children.

Objective: To study the relationship between the age and severity of Type 1 diabetes in children 0 - 5 years and more than 5 years of age admitted to Aseer Central Hospital, Southwestern Saudi Arabia over a 7-year period. Materials and Methods: A retrospective review of children less than 13 years of age with Type 1 diabetes admitted to the Pediatric Department, between 1st January 2000 to 31st December 2006. Results: A total of 181 children with Type1 diabetes were admitted to the hospital during this period. Of these, 27.6% were children 5 years or less, while 72.4% were more than 5 years of age. The duration of symptoms was longer in younger children compared to older patients. Diabetic ketoacidosis was present in 31.4% of the younger children, and in 15.3% of the children more than 5 years old. Hospital stay was also longer in children less than 5 years of age. Most significant differences were in the younger children’s group and affected the biochemical test results. Conclusion: The present study showed that more younger children present to the hospital late, and in a state of diabetic ketoacidosis compared to older patients. Efforts should be directed at improving the knowledge and skills of the primary health care personnel to be able to diagnose and refer these cases earlier.