BackgroundThe available evidence on the role of obesity and body mass index (BMI) on male infertility has been controversial or inconclusive to some extent.ObjectivesThe aim of this study was to investigate the role of BMI on some male-fertility laboratory indicators both among infertile and fertile men in an Iranian population.Methods and materialsA total of 159 male patients who had lived as a partner in an infertile couple for at least 1 year, after regular reproductive activity in their married life, and who sought infertility consultation, were investigated. BMI was assessed, and a morning blood sample was taken assessing serum levels of testosterone, sex hormone-binding globulin, prolactin, luteinizing hormone (LH), follicle-stimulating hormone, and estradiol. Semen-analysis parameters were also measured.ResultsIn this study, it was found that the likelihood of oligospermia was increased at higher BMI values. Obese men were found to be 3.5 times more likely to have oligospermia than those with normal BMI. BMI was not found to be associated with mean numeric values of the semen-analysis parameters, including sperm count, sperm morphology, and sperm motility. BMI was not significantly correlated with some hormone levels, such as LH, prolactin, and LH/follicle-stimulating hormone ratio. However, a statistically significant association was observed between BMI and estradiol (P < 0.01), sex hormone-binding globulin (P < 0.001), and also the testosterone/estradiol ratio (P < 0.001). A different pattern of associations in this study was observed when the associations between BMI and sexual hormone levels were compared between fertile and subfertile/infertile men.ConclusionThe association explored between BMI and some sexual hormones and semen characteristics, as well as different patterns of this association between fertile and subfertile/infertile men, will be of help to broaden our understanding of the effect of obesity on some male reproductive physiologic characteristics among fertile and infertile men.

Nocturnal enuresis is a common problem among children. Hypercalciuria has been proposed as an important etiology of bedwetting. We investigated the incidence of hypercalciuria among children with nocturnal enuresis and age- and sex-matched healthy controls. In this case–control study 118 children with nocturnal enuresis and 100 age-, sex-, and educational district-matched healthy controls were recruited. Urine samples were obtained from each subject twice: immediately after awakening and 2 hours later at school. Urinary calcium and creatinine levels were measured and the subjects with a urinary calcium/creatinine ratio more than 0.2 were considered as hypercalciuric. Serum Ca, P, Na, K, and PTH levels were measured for all hypercalciuric subjects. The mean urine calcium to creatinine ratio in the second urine sample was 0.070±0.06 mg/mg and 0.050±0.046, respectively in the case and control groups (P=0.008). There were 12/118 and 3/100 hypercalciuric subjects in the case and control groups respectively (P=0.032). The serum Ca, P, Na, K, and PTH levels were in normal range in all hypercalciuric subjects. In our study there was a significant difference in the frequency of hypercalciuria among children with nocturnal enuresis and healthy controls, so we can suggest adding the measurement of urine electrolytes especially the calcium level in patients with nocturnal enuresis.

Objective Comparison of active vs passive primary healthcare function in rural with urban setting at determine of delay to diagnosis and treatment of tuberculosis and its outcomes in West Azerbaijan province, Iran, at 2004e2009. Material and Methods In this perspective study we used years TB new cases data that have been recorded by TB management center in West Azerbaijan province. Patient and health system delay were determined as number of days between onset of symptoms to diagnosis and diagnosis to start of treatment respectively. Results At comparison of domicile, both of patient and health delay mean days were more in urban patients (respectively 241 vs 133, p value¼0.02 and 11 vs 7, p value¼0.006). In rural patients, females at comparison of males had more mean total time delays (163 vs 115, p value¼0.01). Despite of higher mean of total delays in extra pulmonary to pulmonary at both of domicile (respectively urban 278 vs 232 and rural 197 vs 97), there was significantly difference in rural regions (p value¼0.0001). Default rate in rural regions was less than urban settings (respectively 3.53% vs 6.08%) and whereas success rate was more than it (respectively 81% vs 79%). Conclusion At regard to health system policy in Iran that primary healthcare for tuberculosis in rural regions is active whereas urban setting is passive, it seems there is urgent need to change of policy in case finding and case holding of patients in urban area to decrease time delays and increase positive outcomes. Objective To determine of the spatial distributions of tuberculosis (TB) and effect of patient distance from the health center on default or interrupted therapeutic outcomes in Urmia, Iran, during 2004e2009. Material and Methods In this cross sectional study we used the data of 452 new TB cases, which have been recorded by TB management center in Urmia, capital of West Azerbaijan province, during a fiveyear period. In order to identifying the significant geographical clusters, we used the "Average Nearest Neighbour" method. Linear regression method was used to determine linear correlation between patients distance and number of default and interrupted therapeutic outcomes. Results Five countryside areas had significantly spatial clusters of TB (p<0.0001). As the distance of patient from TB health center are increased, the number of the default and interrupted cases were also increased (r 2 ¼0.25, p¼0.04). In comparison with the number of default and interrupted cases and the mean distances of TB health center, wherever mean distance was more than 1 Km, number of default and interrupted cases were more than 3 (p¼0.02). Conclusion Spatial distributions of tuberculosis disease in Urmia are not randomly and suburban areas need more serious attentions by policy makers and health planners. According to the health system in Iran, health posts has not actively role in treatment of TB patients at urban settings. As a result, if the health posts are contributed to in the TB treatment programs, the patient distance from the treating he...

Objective The objective of this paper is to examine the association between marital status and the risk of HIV infection in the informal settlements of Nairobi. The findings from this study will inform HIV prevention programs, particularly among poor and marginalised groups in the informal settlements. Methods Data are derived from a cross-sectional population-based survey nested in an ongoing Demographic Surveillance System (DSS) in two urban informal settlements in Nairobi city, where a total of about 60 000 individuals living 23 000 households are under surveillance. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample, as well as to assess the association between marital status and risk of HIV infection. Results The HIV prevalence of respondents who were divorced, separated or widowed was 27%, among those who were married was 12%, and among those who were never married was 5%. Married respondents (OR¼1.78; p value<0.05) and those who were divorced, separated or widowed (OR¼4.06; p value<0.001) were significantly more likely to be infected with HIV compared to respondents who were never married. Circumcision was also a significant predictor of HIV infection. Men who were circumcised (OR¼0.36; p value<0.05) were less likely to be HIV positive compared to those who were not circumcised. Conclusion There is need for HIV prevention interventions to adopt a more targeted approach, particularly with regard to designing and implementing programs geared towards addressing the increased risk of HIV infection among married people and those who were formerly married.