Browsing by Author "Abeysundara, I.D.H.P.K."

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A preliminary study on bacteriospermia in males of subfertile couples
(Sri Lanka Medical Association, 2011) Abeysundara, I.D.H.P.K.; Dissanayake, D.M.A.B.; Wijesinghe, P.S.; Perera, R.R.D.P.
INTRODUCTION AND OBJECTIVES: Bacteriospermia is common in subfertile men. Responsible organisms and their antibiotic sensitivity patterns vary between populations Aim of this study was to identify the types of bacteria and their ABST pattern among males of subfertile couples. METHODS: A descriptive cross sectional study was carried out. Semen samples of 105 males from subfertile couples were cultured in blood, chocolate and McConkey agar. Antibiotic sensitivity tests were done using the Clinical and Laboratory Standard Institute technique. RESULTS: Mean age of the study population was 32.77 yrs (rage 22-48 yrs), mean duration of subfertility was 3 yrs (Range 1-12 yrs). In 98 couples there was primary subfertility. Bacterial growth was noted in 63 samples. Positive cultures were found in 58.2% with primary subfertility and in 85.7% with secondary subfertility. A single organism was cultured in 44. Mltiple organisms were cultured in 19 samples. In 21 samples a significant growth of >104 of colony forming units were noted. Organisms found were Streptococci (n=28 out of them 8 were group D), coagulase negative Staphylococci (n=27), Diptheroids (n=T2), coliforms (n=7 of which 3 were Escherichia colt), Staphyhcoccus aureus (n^5), Acinetobacter (n=2), and Candida albicans (n=l). A single antibiotic or a combination which covers most organisms was not found. CONCLUSIONS: In this study population 20% had a significant bacterial growth. Organisms were found to have varied ABST patterns. The effect of bacteriospermia on subfertility needs further evaluation. Acknowledgements: This study was supported by National Research Council (09-69).
A Qualitative study on patients' perceptions of expectant management of first trimester incomplete miscarriage
(Sri Lanka Medical Association, 2012) Wijesinghe, P.S.; Herath, R.P.; Abeysundara, I.D.H.P.K.
INTRODUCTION Efficacy and safety of expectant management of first trimester miscarriage are well known, though the patients’ perceptions and attitudes are less clear. This study was designed to understand the women’s perception of symptoms, acceptability, fertility wishes and care received. METHODS A qualitative study among 25 women who were allocated to the expectant management arm of a randomised control trial, which compared expectant versus surgical management of incomplete miscarriage, was carried out. Interviews were recorded at the end of two weeks from the initial diagnosis based on five themes, which were transcribed and analysed. RESULTS Out of the 25 interviewed, two had to undergo surgical evacuation due to failed expectant management. Excessive bleeding was the main concern especially for employed women. Ideas and beliefs of family members influenced the women’s experience. Majority preferred expectant management in a possible future event. Many expected to conceive again but preferred to delay a pregnancy even in the absence of any contraindications. Inadequate knowledge of expectant management led to dissatisfaction regarding the care received. CONCLUSIONS Better understanding on the natural course of events in spontaneous miscarriage will help not only the patient but also the relatives in accepting expectant management of first trimester miscarriage and influence their ideas, beliefs and feelings. Improved health education, counselling, and symptomatic relief are important aspects in improving the overall quality of care.
A study on the relationship between bacteriospermia and quality of seminal fluid in subfertile men
(University of Kelaniya, 2013) Abeysundara, I.D.H.P.K.
OBJECTIVES: To determine the presence of non specific bacteria in seminal plasma, describe its relationship with semen quality, assess the efficacy of sperm preparation to clear bacteria from seminal plasma in males of subfertile couples, and evaluate the relationship of bacteriospermia to bound antisperm antibodies (IgG ASAs). METHODOLOGY: A prospective descriptive cross sectional hospital and laboratory based study was carried out in three parts. A total of 570, 118 and 95 asymptomatic males of subfertile couples were included in first, second and third parts of the study respectively. A seminal fluid sample of each male was cultured in blood, chocolate and McConkey agar. Seminal fluid analysis, detection of bound IgG ASA, swim up and density gradient sperm preparations were carried out. RESULTS: In first part of the study, out of 570 semen samples studied 268 (47.01%) were pathozoospermic and 302 (52.98%) samples were normozoospermic. Growth of a single organism was found in 360 (63.15%) samples and 210 (36.8%) were negative for bacteria. Organisms found were Streptococcus species, Staphylococcus species, Coliform species, Proteus mirabilis, Corynebacteriutn species, Acinetobacter species, Bacillus species and Candida albicans. In samples with; Staphylococcus aureus and Corynebacterium species mean (SD) volume and total progressive motile sperm count (TSE) were significantly low. Escherichia coll made the semen samples alkaline. In the second part of the study, samples prepared with swim up method, showed a positive bacterial growth in 49 (72.05%) pre-processed and 16 (23.52%) processed samples (P<0.001). Samples prepared with density gradient method, showed a positive bacterial growth in 37 (74%) pre-processed and 18 (36%) processed samples (P0.001). There was no significant difference of bound IgG ASAs between culture positive and culture negative samples. CONCLUSION: Presence of Staphylococcus aureus, Corynebacterium species and Escherichia coli in seminal fluid is associated with alter semen quality. Both swim-up and density gradient methods significantly reduced bacteria, but total clearance was not achieved. Presence of bacteria in semen does not necessarily signify a disruption of the blood testes barrier.
A study on the relationship between bacteriospermia and quality of seminal fluid in subfertile men
(2013) Abeysundara, I.D.H.P.K.