ABSTRACT
In this review, we discuss the treatment options for male hypogonadism and the associated benefits and potential short- and long-term risks. The choice for treatment may depend on the cause of hypogonadism and the desire for maintaining or improving fertility. We also highlight surgical management of male hypogonadism. Comprehensive searching strategy through Well-known medical databases [MIDLINE/ PubMed, and Embase] searching articles that published in English language up to December 2017, and discussing the surgical management of male hypogonadism. Malehypogonadism is identified by the presence of symptoms or signs of male hypogonadism and consistent serum testosterone levels that are below the normally accepted adult male range. Once the medical diagnosis is confirmed, the primary goal of treatment is testosterone substitution to accomplish serum testosterone levels that remain in the mid-adult range and the symptoms and signs of hypogonadism are eliminated. Recent developments led to numerous delivery systems for testosterone. For patients with primary hypogonadism testosterone therapy is the approach of choice. The patient needs to be completely informed about expected benefits and side-effects of the treatment option. The option of the preparation should be a joint decision by a notified patient and the doctor
ABSTRACT
Background: the occurrences of diabetes mellitus and diabetic nephropathy have increased quickly in the past few decades and have become an economic burden to the healthcare system in KSA. Diabetic nephropathy is a major complication of diabetes mellitus and is a primary cause of end-stage renal disease [ESRD]. The occurrence of non-diabetic renal disease [NDRD] in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse diabetic nephropathy, whereas some cases of non-diabetic renal disease are readily treatable and remittable. However, diabetic nephropathy is known to co-exist with non-diabetic renal disease in a poorly defined population of patients with type 2 diabetes mellitus. This study estimated the pervasiveness of co-existing diabetic nephropathy and non-diabetic renal disease in Saudi patients
Methods: data were retrospectively analyzed from 122 patients with type 2 diabetes mellitus who had experienced a renal biopsy between February 2014 and June 2017 at King Abdulaziz Hospital, region[s], KSA. Male patients numbered 75 [61.5%] of the study population. The biopsies were performed as urinary abnormalities or renal functions were atypical of a diagnosis of diabetic nephropathy. Biopsy samples were examined using light, immunofluorescence [IF] and electron microscopy [EM]. Clinical parameters were recorded for each patient at the time of biopsy
Results: nineteen of 122 diabetic patients [8%] had co-existing diabetic nephropathy and non-diabetic renal disease. These patients showed clinical features and pathologic characteristics of diabetic nephropathy, containing a high prevalence of diabetic retinopathy [88.8%], a long duration of diabetes, increased thickness of the glomerular basement membrane [GBM] and mesangial expansion. Nonetheless, they similarly presented with clinical findings which were inconsistent with diabetic nephropathy, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A [IgA] nephropathy was apparent in 5 out of the 10 patients [50%], tubulointerstitial lesions were found in two patients [20%], membrano-proliferative glomerulonephritis [MPGN] in two patients [20%] and membranous nephropathy [MN] in one patients [10%]
Conclusion: retrospective analysis of biopsy data suggests that approximately 8% of Saudi patients with type 2 diabetes mellitus may have co-existing diabetic nephropathy and non-diabetic renal disease. The most common histological diagnosis in our small series was IgA nephropathy
ABSTRACT
Background: Non-alcoholic fatty liver disease [NAFLD] is the most common chronic liver disease that exposes patients to a great risk of emerging cardiovascular diseases and could develop to cirrhosis or hepatocellular carcinoma if left unmanaged
Objective of the Study: this article is intended to provide an overview and explore the optimal intervention for management of NAFLD in the short and long term
Methods: Electronic search in the scientific database from 1966 to 2017 [Medline, Embase, the Cochrane Library as well as NHS center websites were searched for English Publications were obtained from both reprint requests and by searching the database. Data extracted included authors, country, year of publication, age and sex of patients, epidemiology, geographical distribution, pathophysiology, risk factors, clinical manifestations, investigations and types of surgical treatment
Conclusion: It was concluded from the extensive review of the literature that Lifestyle modification including diet, physical activity and controlling metabolic disorders are the cornerstone in current management of NAFLD. Nevertheless, Insulin-sensitizing agents and antioxidants, particularly thiazolidinediones and vitamin E, seem to be a very promising pharmacologic treatment for non-alcoholic steatohepatitis, yet further long-term multicenter studies need to be conducted for confirmation and assessment