ABSTRACT
One of the challenges in the management of primary monosymptomatic enuresis [PME], especially in adolescents, is response failure to medical regimens such as desmopressin. This prospective study aimed at addressing the efficacy of sertraline in the treatment of 25 adolescents [13-18 year old] with PME having experienced failure to previous desmopressin therapy. Patients were recommended to take one oral tablet of sertraline [50 mg] every morning after meal for 3 months. The patients were followedup every 6 weeks, the final visit being 6 months after treatment termination. Comparing the number of wet nights in the pretreatment nocturnal records with the follow-up visits revealed a significant reduction [P=0.01]. The primary efficacy outcome was achieved in 18 [72%] of the 25 patients; 12 patients had full response, whereas six patients showed partial response. Four [16%] of the 25 children presented with a relapse after 6 months of follow-up. Drug-related adverse events were rare. Sertraline effectively reduced the number of wet episodes in adolescents with PME who had experienced failure to desmopressin therapy. With respect to the favorable efficacy outcome of this medication and the scarce drug-related adverse effects, sertraline can be proposed as a novel treatment for PME
ABSTRACT
OBJECTIVE: This study sought to evaluate platelet volume indices (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [P-LCR]) in varicocele patients, and compare it with platelet volume parameters in healthy controls. METHODS: This cross-sectional study involved 2 groups: group 1 included 51 varicocele subjects and group 2 consisted of 50 healthy control subjects of similar ages. Peripheral venous blood samples were collected with ethylenediaminetetraacetic acid-K2 anticoagulant between 8:30 AM and 10 AM following an overnight fast. Platelet volume parameters (MPV, PDW, and P-LCR) were measured in both groups within 2 hours of sampling. RESULTS: The mean PDW, MPV, and P-LCR were 13.9+/-2.5%, 10.1+/-1.3 fL, and 27.3+/-7.8% in varicocele patients, respectively, and were 12.6+/-2.4%, 9.3+/-1.1 fL, and 21.9+/-6.4% in the control group, respectively. The mean PDW, MPV, and P-LCR were significantly higher in the varicocele group than the control group. CONCLUSION: The results of the present study suggest that vascular components may play an important role in the pathophysiology of varicocele; therefore, there is a great need for prospective studies to confirm this relationship.
Subject(s)
Humans , Blood Platelets , Cross-Sectional Studies , Mean Platelet Volume , Varicocele , Vascular DiseasesABSTRACT
The etiology, pathophysiology and treatment of Peyronie's disease remain unknown. Few medical therapies have positive effect on this condition. However, penile curvature is the major symptom of Peyronie's disease, which can be treated by surgical reconstruction. There are many surgical techniques for correcting penile deformity but there is the lack of a gold standard procedure. We present a surgical technique to correct penile deformity in Peyronie's disease. In this case series study, we treated 14 patients with stable Peyronie's disease with significant curvature that precluded intercourse. We excised the fibrous area and the gap was covered with a graft removed from the crural segment of the corpora cavernosa. In 3, 6 and 12 months follow-up there were straightening of penis in 92.8, 92.8 and 78. 2% of patients and acceptable erectile function in 100, 92.8 and 85.7%, respectively. Thirteen and eleven of 14 patients were satisfactory with the cosmetic and functional result of surgery, respectively. No severe perioperative complication was noted. Present technique may be considered as a treatment option in patients with curvature due to Peyronie's disease. Tunica albuginea auto graft from crural segment seems to be an appropriate grafting material for this technique