Background:Current data regarding infertility suggests that male factor contributes up to 30% of the total cases of infertility. Semen analysis reveals the presence of spermatozoa as well as a number of non-sperm cells, presently being mentioned in routine semen report as “round cells” without further differentiating them into leucocytes or immature germ cells.Aim:The aim of this work was to study a simple, cost-effective, and convenient method for differentiating the round cells in semen into immature germ cells and leucocytes and correlating them with total sperm counts and motility.Materials and Methods:Semen samples from 120 males, who had come for investigation for infertility, were collected, semen parameters recorded, and stained smears studied for different round cells. Statistical analysis of the data was done to correlate total sperm counts and sperm motility with the occurrence of immature germ cells and leucocytes. The average shedding of immature germ cells in different groups with normal and low sperm counts was compared. The clinical significance of “round cells” in semen and their differentiation into leucocytes and immature germ cells are discussed.Conclusions:Round cells in semen can be differentiated into immature germ cells and leucocytes using simple staining methods. The differential counts mentioned in a semen report give valuable and clinically relevant information. In this study, we observed a negative correlation between total count and immature germ cells, as well as sperm motility and shedding of immature germ cells. The latter was statistically significant with a P value 0.000.

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Axillary arch muscle or the Langer's muscle is one of the rare muscular variation in the axillary region. It is the additional muscle slip extending from latissimus dorsi in the posterior fold of axilla to the pectoralis major or other neighbouring muscles and bones. In the present article a case of 68 yrs old female cadaver with axillary arch in the left axillary region is reported. It originated from the anterior border of lattissimus dorsi and merged with the short head of biceps and pectoralis major muscles. The arch was compressing the axillary vein as well as the branches of the cords of brachial plexus. The presence of the muscle has important clinical implications, as the position, unilateral presence, axillary vein entrapment, multiple insertions makes the case most complicated. Recognising the presence of axillary arch muscle in such complex form is important in clinical practice as the arch causes the difficulties in staging lymph nodes, axillary surgery, thoracic outlet syndrome, shoulder instability or cosmetic problems. The anatomy, embryological and clinical importance of this muscular variation is discussed in this paper

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