Objective:To determine whether weight loss in obese men improves reproductive hormones. Design: Prospective interventional study. Setting: Infertility clinic and weight loss centers. Patients: All obese men attending infertility center from April 2012 to May 2015 (n = 105). Intervention(s): Diet counseling and exercise. Materials and methods: Obese men aged 25-40 years (mean age = 32.5 ± 7.5) with BMI more than 25 kg/m 2 were recruited for the study. The subjects underwent a weight loss intervention and were followed up for 1-year post intervention. Their semen parameters were checked before and after weight loss. Main outcome measures: Collected reproductive parameters included testosterone (T), sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) serum hormonal values. A paired t test was done to evaluate differences across the before and after groups. Chi-square/Fisher exact test was used to find the significance of study parameters on a categorical scale between two or more groups. Results: The mean BMI was significantly higher before weight loss (33.2) than after weight loss (30.4) in obese men. The weight loss increased the T to 35.40 ± 20.51 ng/mL compared with 27.16 ± 20.71 ng/mL, and SHBG to 23.72 ± 9.01 µg/dL compared with 19.18 ± 10.44 µg/dL, whereas FSH and LH were nonsignificant. Conclusion: The study showed that a high BMI at the baseline was associated with low values of serum T and SHBG. FSH and LH were considerably low in morbidly obese men before weight loss. Weight loss was associated with an increase in serum T and SHBG. FSH and LH were not statistically significant after weight loss except in morbidly obese men who showed clear aromatization influence. The hormonal profile among obese men evaluated in this study was characterized by abnormalities in the sex hormones, and weight loss improved some of the hormone levels; however, they were not normalized.
This new classification is based on the analysis of the following:1. The study of Embryological developments of the normal structures and the clefts in the head and neck regions,2. The Clinical presentation of Clefts in the head and neck regions in our series of 146 cases,3. The study of clefts under Rare craniofacial, Branchial [Cervical] and Classifications by various Authors and4. The review of Literature pertaining to the clefts in head and neck regions.The documentation of commonly diagnosed and treated cleft lip and palate anomalies have remained unsatisfactory. As the regular cleft lip and palate falls within the purview of this new classification, a separate classification of Rare Craniofacial clefts can be avoided. This is an attempt made to bring all varieties of cleft deformities in the head and neck region under one Classification and to plan and execute better techniques in the field of assessment and management.
Background: The multifactorial etiology of clefts includes both genetic and environmental factors. Many studies were conducted to identify the genetic basis of the etiology of clefts and effect of maternal folic acid intake in reducing the risk of clefts.. Not many studies conducted about other environmental factors causing clefts. The present study is to find out the non-genetic factors associated with the nonsyndromic clefts. The maternal periconceptional intake of folic acid, family history, parental age, socioeconomic status, parental alcoholism and smoking, and parental occupational exposure are the factors included in the study. Materials and methods:The study group comprised 400 subjects with 200 Nonsyndromic cleft cases and 200 healthy controls from the South Indian population. The data was collected in a detailed questionnaire by direct interview and analyzed the data using SPSS version 21. Logistic regression model was used to measure the odds ratio(OR) for the independent variables and Chi-square analysis was performed to find out the significance. Results:The family history of clefts was found in 10.6% cleft cases (p value= 0.001). The risk of cleft was increased in cases with no maternal folic acid intake in their first trimester of pregnancy (p value= 0.001). Parental age more than 35 years (p value= 0.004) and low maternal education (p value= 0.001) were also found as the risk factors to cleft. Low socioeconomic background was another risk factor (p value= 0.001). Parental occupational exposure in terms of pestcidal exposure was found significant but not the parental medication and smoking. Conclusion:Maternal consumption of folic acid and multivitamins during the periconceptional period to be assured to prevent the occurrence of oral clefts. Family history of cleft increases the risk of cleft and the risk is further increased when cleft is present in parents or siblings. And maternal age more than 35 years is found more significant than the paternal age . Consanguinity showed 4 fold increase in clefts. Maternal diet is a prime factor as it is directly related to folic acid and vitamin supplementation apart from the socioeconomic status of family.
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