Kallmann syndrome and deafness: an uncommon combination: a case report and a literature review

Background: kallmann syndrome [Kal S] is an isolated form of hypogonadotrophic hypogonadism in combination with a defect in smell sensation. Depending on the genetic form of the disease, a number of non-reproductive, non-olfactory abnormalities may also be existent. In the present report, we describe a male with Kal S associated with hearing loss, and the successful treatment of his sexual and reproductive defects

Case: a 23-year-old Caucasian man presented with a lifelong lack of erection and ejaculation. The patient reported also anosmia combined with loss of hearing ability. A diagnostic work-up identified the presence of Kal S associated with sensorineural hearing loss. Administration of gonadotrophins regained the erection and a viable-sperm containing ejaculation

Conclusion: lack of erection and ejaculation are important components of delayed puberty which could lead to diagnosis of Kal S. The existence of a hearing impairment in the reported patient makes the recommendation to screen the hearing ability in Kal S of utmost importance

Urolithiasis in patients on chronic hemodialysis

Reports were conflicting with respects to the composition of calculi formed in patients who were kept on hemodialysis and also on the pathogenetic factors involved in their formation. This study was, therefore, conducted to investigate these debates. Patients and methods: renal calculi form 38 hemodialysis patients were subjected to morphological study with microscopic examination and constitutional analysis with infrared spectrophotometry. patients' calculi were mainly consisting of oxalo-protein calculi with > 30% calcium oxalate as a total stone content [18 patients, or 47%]. They could be a consequence to metabolic factors, such as high urinary oxalate and low urinary citrate concentration, and to iatrogenic factors, namely vitamin D3 and calcium salts supplementation. In 14 [37%] patients, calculi were made of sole proteins or in association with < 30% calcium oxalate, and were observed mainly in patients with primary glomerular disease. Aluminum-magnesium urate calculi, which may be related to aluminum overload were seen in the remaining 6 [16%] patients. metabolic and iatrogenic conditions come as the predominant factors incriminated in pathogenesis of most calculi formed by hemodialysis patients. The precise analysis of such calculi is therefore, higher recommended as it can offer useful information on pathogenesis, and hence a possible approach to their prophylaxis

study of different rigiscan patterns in diabetic impotent patients

Twelve patients with insulin-dependent diabetes mellitus [DM] and 12 patients with non-insulin-dependent DM all with erectile dysfunction of more than one month were assessed with history taking, physical examination and nocturnal penile tumescence monitoring using the rigiscan. There was a significant difference in age between patients with insulin-dependent and non-insulin-dependent DM as well as between patients with abnormal and normal rigiscan results. An organic pattern was evident in 62.5% of the patients with no significant difference between insulin-dependent and non-insulin-dependent DM. There was no significant correlation between the different durations of DM and results of rigiscan monitoring. The different rigiscan patterns were low amplitude, uncoupling, dissociation, shortened episode and no events. There was a correlation between the clinical findings and the rigiscan patterns. It was concluded that rigiscan monitoring was recommended to differentiate between organic and psychogenic causes of ED in diabetics. It may also give a clue to the underlying organic cause, thus directing towards the specific step needed in diagnosis

Isolated asthenospermia evaluation of the possible causes in 179 infertile patients

A total of 179 patients with isolated asthenospermia as detected by semen analysis was evaluated by history, clinical and Doppler examinations and laboratory studies. These studies included microbiological culture for aerobes, anaerobes and Chlamydia trachomatis and also immunological screening to detect sperm-coated antisperm antibodies using mixed antiglobulin reaction. Transmission electron microscopy was also performed to check for any sperm tail ultrastructural anomalies. The diagnostic scheme showed that varicocele, genital infection, antisperm antibodies [AsAb] and ultrastructural tail anomalies were present in 54% of the patients as a single etiological factor. In 22.4% of the patients, these identified pathologies existed in different combinations per patient. The remaining 23.6% of the patients were grouped as idiopathic asthenospermia. In conclusion, isolated asthenospermia may be caused by several etiologies that may exist as single or multiple in the patient. Therefore, multidisciplinary approach is required during the evaluation of isolated asthenospermia