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Background: The study aimed to examine the effect of leukocytospermia on sperm quality and the levels of seminal adenosine deaminase (ADA) enzyme in males attending an infertility clinic in a tertiary hospital and to detect the association, if any, between seminal ADA and sperm quality. Methodology: Consenting male subjects, between 21 and 45 years, attending the infertility clinic and qualifying the eligibility criteria were recruited following informed consent. The collected semen samples were analyzed for the routine parameters based on the WHO protocols and for sperm DNA fragmentation. The seminal leukocyte count was detected using the peroxidase method, and the seminal ADA was assessed using spectrophotometry. Results: Samples from 110 participants were included in the study; leukocytospermia was detected in 33% of the samples. A significant reduction in the sperm quality with respect to conventional semen parameters (sperm motility and sperm vitality) and sperm DNA fragmentation index (SDFI) was noted in the presence of leukocytospermia. Furthermore, a significant positive correlation between the levels of seminal ADA and SDFI was noted (P = 0.000, r = 0.412). Conclusion: The sperm motility and DNA integrity are significantly compromised in the presence of leukocytospermia when the leukocyte count is > 1 million/mL of semen as well as 0.5–1 million/mL of semen. The positive correlation noted between seminal ADA levels and increased sperm DNA damage paves way for the possibility of seminal ADA to be an indicator of silent male genital tract inflammation as well as low-quality semen.

The small intestine perforation in an obstructed inguinal hernia is rare. A sixty-seven-year-old male had a history of sudden collapse at his farm. His relative took him to the Government Hospital and then got referred to our tertiary care center the next day. He had severe abdominal pain, emesis, and low-grade fever. The total survival period was thirty-seven hours. The long-standing pathology in the ileum, i.e., the content of obstructed hernia, resulted in perforation. The cause of death opined was peritonitis due to ileal perforation in obstructed inguinal hernia. Our case highlights the significance of pathophysiology, mechanism, and the cause of death in a long-standing obstructed inguinal hernia. Highlights/Key Points • A sixty-seven-year-old male had a history of collapse with onset of abdominal pain at his farm during evening hours and died during treatment. • On autopsy, we observed the features of peritonitis as a result of ileal perforation in long-standing left inguinal hernia • We have discussed the mechanics of perforation and its related pathology. • We have highlighted the importance of meticulous autopsy, pathophysiology, mechanism, and the cause of death in an obstructed inguinal hernia. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare no conflict of interest.