It is my pleasure to meet all of you through this issue of the journal. The whole universe spins on an invisible balance between two forces. The continuation of the human race is not an exception to this rule. The contribution from male and female is essential for a healthy progeny. Though the females are commonly blamed for infertility, it is a fact that male factors are equally contributory. The original and review articles in this issue focus on male factor ranging from congenital factors to environmental factors.

To study the motility changes in the human spermatozoa after exposure to Radio Frequency Electromagnectic Waves (RF-EMWs) emitted by the cell phone during the call attended mode from different directions.

To identify the sperm parameters which influence the success of an Intra uterine insemination (IUI) cycle. Design: A retrospective study conducted at the Dept. of Reproductive Medicine, Chettinad Super Specialty hospital, Chennai.

Leucocytospermia is the nomenclature given to semen sample containing more than 1 mill/ml leucocytes. This is often considered to be a sign of infection and patients are given broad spectrum antibiotics. The objective of this study is to find out the significance of leucocytes in semen samples of patients attending our infertility clinic.

Hypogonadotropic hypogonadism contributes to 15% of anovulatory infertility1 . Hypogonadotropic hypogonadism is encountered rarely in routine clinical practice and leads to surprises at times as in this case.

Pemphigus vulgaris is a rare autoimmune disorder which affects the skin and mucous membrane. It affects both sexes equally. We had a patient who underwent ART treatment for infertility, affected by this disorder during treatment. Now she is in a dilemma to decide regarding the frozen embryos.

Thyroid storm is a rare complication of uncontrolled hyperthyroidism which has multisystem involvement and high mortality if untreated. We present a case of thyrotoxicosis progressing to thyroid storm which was precipitated by infection. The clinical presentation was confounded by the presence of underlying mitral regurgitation and atrial fibrillation.

Lichen planus (Greek leichen, “tree moss”; Latin planus, “flat”) is a unique, immunologic mediated inflammatory disorder, that affects skin, mucous membranes, nail & hair. It is a disease of unknown etiology and is characterized by purple, polygonal, pruritic, flat topped papules. Linear lesions in lichen planus can be due to isomorphic phenomenon or due to mosaicism, where the lesion follow Blaschko`s lines.The latter are unique lines which may be followed by other conditions like epidermal nevi, psoriasis, lichen striatus, Darrier`s disease and porokeratosis to name a few2,3. Here we report an interesting presentation of Blaschkoid lichen planus in association with atopy,in a 22 year old woman.

Giant cell tumour (GCT) of distal radius follows a comparatively aggressive behaviour. Wide excision is the management of choice, but this creates a defect at the distal end of radius. The preferred modalities for reconstruction of such a defect include vascularized/non-vascularized bone graft, osteoarticular allografts and custom-made prosthesis. We here present our experience with wide resection and non-vascularised autogenous fibular grafting for Giant Cell Tumour of distal radius.

Acquired haemophilia is a rare haemorrhagic disorder which can present with mild to severe bleeding and can be potentially life threatening. Diagnosis of acquired haemophilia can be difficult because of the rarity of its presentation. It has been found to be associated with pregnancy, inflammatory bowel disease, hepatitis B and C, hypothyroidism and autoimmune disorders. We present the case of a 45 year old female patient with gum bleeding for two weeks with no family or personal history of a bleeding disorder. Further laboratory and radiological evaluation revealed a rare association of acquired haemophilia with hypopituitarism. Association of acquired haemophilia with hypothyroidism although by itself rare , is a known one, but acquired haemophilia with hypopituitarism (empty sella) is a rare one.

Pseudocholinesterase deficiency can result in impairment of the metabolism of neuromuscular blocking agents like succinylcholine and mivacurium. We report the case of a 33 year old patient with known antithrombin III deficiency who underwent caesarean section under general anesthesia following which she had delayed recovery from anaesthesia, due to pseudocholinesterase deficiency.

Ropivacaine- a relatively new long acting local anaesthetic agent is a pure S-enantiomer.Local anesthetic toxicity commonly affects the cardiovascular and central nervous systems(CNS), with CNS symptoms being more diverse varying from numbness of tongue,visual disturbance and muscular twitching to more serious manifestations like convulsions, coma, respiratory arrest, and cardiovascular arrest. Brachial plexus block is a frequently used technique for upper limb procedures and is more desirable to use a longer acting local anesthetic for the same. Among the long acting local anaesthetics, ropivacaine is less toxic compared to bupivacaine with only few cases of cardiac or central nervous system toxicity being reported. We report a case of generalised tonic clonic seizure (GTCS) that occurred in a patient during administration of ropivacaine for brachial plexus block.

Hereditary haemorrhagic telangiectasia(HHT) also known as Osler-Weber-Rendu disease is a rare autosomal dominant disorder that causes vascular dysplasias of all the blood vessels and results in a tendency for bleeding. It has a triad of mucocutaneous telangiectasiae, recurrent epistaxis, positive family history.We report a case of HHT in a 60 yr old male who was admitted with recurrent epistaxis, multiple mucosal and skin lesions, strong family history associated with chronic parenchymal liver disease which is a rare association.

Pneumothorax is a potentially serious complication associated with blunt injury to the chest wall. Diagnosis is usually made with a combination of clinical signs and symptoms which may be subtle, and plain chest radiography. However supine chest x-ray has low sensitivity for traumatic pneumothorax. Diagnosis of pneumothorax in the perioperative area can be difficult due to lack of ready availability of equipments and trained personnel. Ultrasound allows anaesthetist to quickly rule out this potentially life threatening complication in the perioperative period.

Monckeberg’s medial sclerosis is a degenerative disease of unknown etiology, characterised by dystrophic calcification of tunica media of small and medium sized arteries1 . It is a poorly understood condition which can be associated with generalised atherosclerosis, coronary artery disease and chronic kidney disease. We report a case of Hemorrhagic stroke with absent peripheral pulses and extensive arterial calcifications. On extensive evaluation and ruling out various other causes, a diagnosis of Monckeberg’s medial sclerosis as the cause was made.

Chronic Myeloid Leukemia (CML) is a commonly encountered hematological malignancy, characterised by increase in erythroid, myeloid cells and platelets in the peripheral blood as well as marked myeloid hyperplasia in the bone marrow. The typical symptoms at presentation are fatigue, anorexia and weight loss, and the most common physical finding is splenomegaly. The presence of Philadelphia chromosome [t(9:22)] is the molecular abnormality found in 95% of patients. Imatinib, an inhibitor of BCR-ABL tyrosine kinase, is the standard treatment for chronic phase of CML.

Dr. Mukherjee along with Prof. Sumit Mukherjee, a cryobiologist, and Dr.Saroj Kanti Bhattacharya, a gynecologist, worked on a method of in vitro fertilization that was used successfully on a patient with damaged fallopian tubes. He presented his findings in the section on ovum implantation at the 5th International Congress on hormonal steroids held in New Delhi in Oct-Nov 1978.

The decline in the quality of semen parameters over the last few decades can be partly attributed to lifestyle and environmental factors. Recent trends in lifestyle including sedentary jobs, obesity, smoking, alcohol consumption, recreational drug abuse along with environmental factors like pollution and toxic chemical substances have been found to have adverse effects on the functional capacity of spermatozoa thereby impairing male fertility. A positive change in quality of life like healthy dietary habits, regular physical exercise and avoidance of smoking, alcohol intake and recreational drug abuse may reduce the damage incurred to the spermatozoa, thereby increasing the male fertility potential.

Testicular Descent is enigmatic in the sense the exact interaction between anatomical, hormonal and molecular factors coordinating the various phases of descent remains to be elucidated. This review explores testicular descent in various species along with anatomical and hormonal factors regulating descent. But why does the testis not descend? Both bilateral and unilateral undescended testis has an effect on the individual’s future fertility. We have reviewed the literature and presented briefly on the various causes that could lead to testicular undescent. Lastly we have also given a hypothesis that could account for testicular undescent.

Initially, I didn’t have much interest to join this IVF discipline, I was working as a clinician, as a gynaecologist and obstetrician, doing surgeries partly related to infertility. I was doing a lot of oncology surgery. In 1970’s, there was no radiotherapy, or chemotherapy, so I had to do oncology radical, ultraradical surgeries. But that did not give me an incentive as the results were not very good. While doing that I learned the technique of fine dissection of the tissues, so I moved on to congenital malformation of the female genital tract, because that was also an area that was not touched upon by the ordinary gynaecologists.

In the early days of vaccination, the field weathered the share of criticism due to any scientific advance. The positive outcomes of vaccination were balanced by the ambiguity of statistical evidence for its safety1 . Alfred Wallace who co-discovered Evolution with Darwin, advocated the exercise of caution2 . Anti-vaccinationism found a place in the Nazi theories of racial superiority and exploitation of evolutionary theory. Sample an argument: ‘Immunity to disease indicates that the individual is robust, therefore vaccination prevents the operation of natural selection. ’Such objections are perverse and at odds with the chief object of medicine, namely to provide succour to the sick3 . The utility of vaccination as a method to create memory in the immune system using the agent of disease itself but without its virulence factors is today firmly established. Vaccine research has yielded effective prophylaxis in many cases. We are heavily anticipating vaccine breakthroughs for many more conditions, including some cancers.