Erectile dysfunction in patients with nonalcoholic fatty liver disease

Background and study aims: There is a lack of studies on erectile dysfunction [ED] in patients diagnosed with nonalcoholic fatty liver disease [NAFLD]. The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients

Patients and methods: We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide

Results: The mean age of the study population was 42.4 +/- 7.7 years [79.1% >/= 40 years]. Of the 192 patients with NAFLD, 88 [45.8%] had ED, 28 [14.6%] had metabolic syndrome, 25 [13%] had type-2 diabetes mellitus [DM], and 131 [68.2%] had insulin resistance [IR]. The mean level of serum testosterone was 3.17 +/- 2.94 ng/mL, while the mean insulin resistance index was 2.9 +/- 1.7. Mild ED [38.6%] was the most frequent grade of ED. Age >/= 40 years [odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7-24.1; p- 0.006], IR [OR 5.9; 95% CI 1.7-20.6; p- 0.005], and low serum testosterone [OR 5.1; 95% CI 1.5-17.1; p- 0.009] were the predictors of ED

Conclusions: ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis

Dipstick spot urine pH does not accurately represent 24 hour urine PH measured by an electrode

ABSTRACT Objectives To determine whether spot urine pH measured by dipstick is an accurate representation of 24 hours urine pH measured by an electrode. Materials and Methods We retrospectively reviewed urine pH results of patients who presented to the urology stone clinic. For each patient we recorded the most recent pH result measured by dipstick from a spot urine sample that preceded the result of a 24-hour urine pH measured by the use of a pH electrode. Patients were excluded if there was a change in medications or dietary recommendations or if the two samples were more than 4 months apart. A difference of more than 0.5 pH was considered an inaccurate result. Results A total 600 patients were retrospectively reviewed for the pH results. The mean difference in pH between spot urine value and the 24 hours collection values was 0.52±0.45 pH. Higher pH was associated with lower accuracy (p<0.001). The accuracy of spot urine samples to predict 24-hour pH values of <5.5 was 68.9%, 68.2% for 5.5 to 6.5 and 35% for >6.5. Samples taken more than 75 days apart had only 49% the accuracy of more recent samples (p<0.002). The overall accuracy is lower than 80% (p<0.001). Influence of diurnal variation was not significant (p=0.588). Conclusions Spot urine pH by dipstick is not an accurate method for evaluation of the patients with urolithiasis. Patients with alkaline urine are more prone to error with reliance on spot urine pH.

Hookworm infection among patients with pulmonary tuberculosis: Impact of co-infection on the therapeutic failure of pulmonary tuberculosis

Objective/background: The aim of this study is to determine the rate of hookworm infection among patients with pulmonary tuberculosis [TB] and to find out if there is a relation between hookworm infection and the therapeutic failure of pulmonary TB

Methods: We carried out a prospective, hospital-based study. The study included 231 naive patients with pulmonary TB, consecutively. Patients were evaluated at the 4th month of therapy for persistence of Mycobacterium tuberculosis infection. All patients had clinical evaluation, laboratory investigations [including sputum culture and stool microscopic examination], and imaging studies [abdominal ultrasonography and chest radiography]

Results: The study population mean age was 42.7 +/- 13.9 years old with 26.8% of them 40 years old or more. Out of 231 patients, 133 [57.6%] were men. Therapeutic failure rate of pulmonary TB was 29.4%. Hookworm infection was diagnosed among 16.5% of patients and 27.7% had diabetes mellitus [DM]. Using multivariate analysis, it was found that age of 40 years or more [odds ratio [OR] 8.4; 95% confidence interval [CI] 1.7-41.3; p = .009], hookworm infection [OR 7.6; 95% CI 1.2-49.9; p = .034], and DM [OR 5.9; 1.2-28; p = .027] were independently associated with therapeutic failure of pulmonary TB among the study population with pulmonary TB

Conclusion: In conclusion, the rate of therapeutic failure of pulmonary TB is high. Besides older age and DM, hookworm infection can reduce the therapeutic response of pulmonary TB. Screening for and control of DM and hookworm infection among patients with pulmonary TB may improve their therapeutic response

Expression of heparanase gene in Egyptian acute leukemia patient

Heparanase is an endoglycosidase that degrades heparin sulfate, the main polysaccharide constituent of the extracellular matrix and basement membrane. Expression of the heparanase gene is associated with the invasive, angiogenic, and metastatic potential of diverse malignant tumors and cell lines. to investigate possible relation/correlation between Heparanase gene expression and quantitation in pediatric Acute leukemia patients and clinicopathologic variables as well as patients outcome in an attempt to determine it's prognostic value and the possibility of using it as a new target for treatment. Forty pediatric acute leukemia patients [20 acute myeloid leukemia [AML] and 20 acute lymphoblastic leukemia [ALL] as well as 11 normal volunteers were analyzed for the expression and level of Heparanase gene using real time quantitative reverse transcriptase polymerase chain reaction [RTQ-PCR] to investigate a possible relation, association, or correlation with the clinical and laboratory features of patients at diagnosis, and patient outcome after treatment and follow up. Comparing the 3 groups as regards the Heparanase gene level there was high statistical significant difference [p<0.001] being maximum in AML and minimum in controls, with mean Relative quantitation [RQ] level 2336.2 +/- 10405.2 in AML ,median 8.0 and range [3.1-46543.0], while mean RQ in ALL was 1.7 +/- 1.0 ,median 1.7 and range [0.1-3.1] and in controls mean was 0.8+/-0.3, median 0.8 and range [0.4-1.4].Comparison between each 2 groups as regards heparanase level was of high statistically significant difference, p value being [p<0.001] when comparing AML/ALL and AML/controls and [p=0.035] when comparing ALL/controls. Cut off value for heparanase gene was calculated using Roc curve and was found to be 1.413 with 80% sensitivity and 100% specificity. According to this cut off level, 20/20 [100%] AML cases were heparanase positive, 12/20 [60%] [[ALL] cases were heparanase positive and 8/20 ALL patients were negative, while all controls [100%] were negative. This was of high statistical significance [p<0.001]. Comparing the overall survival [OS] of AML/ALL there was no statistically significant difference [p=0.2916], while comparing the disease free survival [DPS] of AML/ALL was of statistical significant difference [0.0312]. Comparing the final status of the disease [complete remission [CR]/ progressive disease [PD] or death] as regards the heparanase gene level RQ, showed a high statistical significant difference [p<0.005] with the level being higher in patients with PD/death. There was no significant correlation between all group and heparanase gene level as regards age, TLC, hemoglobin, platelets and peripheral blood blasts [p=0.353,0.704,0.844,0.54 and 0.097] respectively, while there was significant negative correlation on comparing bone marrow blast% and heparanase gene level [r=-0.408 and p=0.09]. Heparanse gene is expressed in acute leukemia being higher in AML than ALL and controls. Patients with higher heparanase gene showed poorer outcome. These findings suggest that heparanase gene may be a novel significant therapeutic target for acute leukemia

Incidence of macular detachment among patients with rhegatogenous retinal detachment

The incidence of rhegmatogenous macular detachment is determined in a consecutive series of 750 patients admitted to the ophthalmology department of Assiut University Hospital in the period from 1980- to 1988. The work included the important factors which may lead to a higher degree a macular involvement in patients with rhegmatogenous retinal detachment