Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial

ABSTRACT Purpose: To compare the efficacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to find the most effective drug with the least number of side effects in treatment of premature ejaculation (PE). Materials and Methods: This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fluoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch. Results: Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fluoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time significantly increased in all groups (p <0.05), but there was no significant difference between the groups (P=0.75). Also, there was no significant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug. Conclusions: All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.

[Effect of valsalva maneuver in prevalence of varicocele]

The prevalence of varicocele in employees of musician and transport units of AJA University of medical sciences was evaluated. In a cross-sectional study 42 musician and 31 individuals from transport unit of AJA University of medical sciences enrolled. The varicocele was evaluated in left and right testis. The prevaIence and grad of varicocele were analysed by chi[2] and P<0.05 was statistically considered significant. The results showed that the prevalence of varicocele in the musician unit [31%] was significantly higher than in the transport unit [10%] [P=0.032], and in the left testis was significantly higher than the right testis. The grad of varicocele in the musician unit was also significantly higher than the transport unit. It seems that the prevalence and grad of varicocele in the left testis are higher than in the right testis and are also high in musicians who their activities are accompany with valsalva manoeuvre

[Study of antibiogram in pediatric pneumococcal meningitis]

Background: appropriate treatment of pneumococcal meningitis especially in children is an important problem due to high mortality, morbidity and multiple drug resistance.We studied antibiogram in pneumococcal meningitis older than two months, Shohada and Imam Hosein hospitals, 1380-1385

Materials and Methods: in this prospective and cross sectional process research we measured antibiogram in 20 positive bacterial culture in CSF with qualitative disck diffusion test

Results: antibiotic resistance of 20 Streptococcous pneumoniae patient was: penicillin R.in 35%,chloramphenical R. in 10%,third generation cephalosporins R. in15%, rifampicin R. in 5%

Conclusion: antibiotic Resistance of our study is compatible with other studies.There is an important rising antibiotic resistance among Streptococcus pneumoniae.Therefore it seems that third generation cephalosporins alone and better with vancomycin is a suitable therapy