Sonographic imaging of the stellate ganglion in healthy adults: An observational study.

The aim of this study is to estimate the normal cross-sectional area and diameter of the stellate ganglion (SG) by ultrasound (US) in healthy adults. The study sample included 80 stellate ganglia in 40 participants (15 males, 25 females), mean age 38 years, mean height 162.5 cm, mean weight 67.8 kg, mean body mass index 25.4 kg/m2. Two radiologists separately obtained US images of the bilateral SG. Each participant was scanned 3 times bilaterally to assess for intra-observer reliability. The mean diameter of the SG was 1 mm (range: 0.1-2). The mean CSA of the bilateral SG was 1.3 mm2 (range: 0.6-3.9). The SG diameter positively correlated with age. Our study demonstrates the ability of US to image the SG and estimate its normal diameter and CSA. Knowledge of how to identify and measure the SG during ultrasound-guided procedures would be expected to decrease the risk of associated complications and help establish normal reference values.

Erectile Dysfunction and Depression Prevalence Among Male Patients with Type II Diabetes.

Background and Objective: Patients with Type 2 Diabetes (T2D) are at substantial risk for developing erectile dysfunction (ED). The primary goal of this study was to assess the prevalence of ED and depression among T2D patients and the associated risk factors. Methods: A cross-sectional study was conducted for adult T2D patients who had a routine clinic visit between January-August 2023. Structured questionnaires formed with two validated questionnaires - the International Index of Erectile Function short form (IIEF-5) and Patient Health Questionnaire (PHQ-9) - were used to screen for ED and depression, respectively. Results: A total of 478 male patients with T2D with a mean age of 59.2 ± 10.8 years, mostly married, with long standing T2D were included. Hyperlipidemia followed by hypertension were the most reported comorbidities. Of the patients, 61.3% had reported no depression and were less likely to have ED or severe ED (p <0.001) and more likely to be physically active and to report no smoking (p <0.0001) when compared to those with depression. Fifty-two percent of the patients reported moderate and severe ED and those were older in age (p = 0.031), had longer duration of T2D diagnosis (p = 0.005), were more likely to have any comorbidities (p <0.05), were less likely to have a university degree and higher income (both p <0.001), were less likely to be on oral hypoglycemic agents (OHA) (p <0.001), had worse glycemic control parameters (p = 0.463), were more likely to have positive urine microalbuminuria (p = 0.019), and were less likely to be physically active (p = 0.048) when compared to patients with no or milder degree of ED. Conclusion: ED is highly prevalent in our study sample, with half of the patients having moderate to severe ED and being more likely to have depression. Older age, long-standing T2D, comorbidities, socioeconomic disadvantage, and sedentary lifestyle were all significantly associated with ED.

Ultrasound imaging of the phrenic nerve at the scalene muscle level.

The aim of this study is to utilize ultrasound to evaluate the normal cross-sectional area (CSA) of the phrenic nerve (PN), at the level of the anterior scalene muscle. The study included 62 PNs in 31 healthy subjects (13 men, 18 women); mean age, 36.6 years; mean height, 161.1 cm; mean weight, 69.6 kg; and mean body mass index 25.8 kg/m2. High-resolution ultrasound images of the bilateral PNs were obtained by a radiologist with 15 years of experience in neuromusculoskeletal ultrasound. Three separate CSA measurements for the bilateral PNs bilaterally were obtained. Images were also reviewed by an experienced neurologist to evaluate for inter-rater variability. The mean CSA of the right PN was 0.54 mm2 ± 0.16. The mean CSA of the left PN was 0.53 mm2 ± 0.18. We believe that the reference values for the normal CSA of the PNs obtained in our study could help in the sonographic evaluation of PN enlargement, as it relates to the diagnosis of various diseases affecting the PN. Furthermore, knowledge of its location and size, at the level of the scalene muscle, could help prevent PN-related complications during interventional procedures in that area. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented.

Ultrasound of the normal vagus nerve cross-sectional area in the carotid sheath.

The aim of this article is to utilize ultrasound to evaluate the normal cross-sectional area (CSA)of the vagus nerve (VN) in the carotid sheath. This study included 86 VNs in 43 healthy subjects (15 men, 28 women); mean age 42.1 years and mean body mass index 26.2 kg/m2. For each subject, the bilateral VNs were identified by US at the anterolateral neck within the common carotid sheaths. One radiologist obtained 3 separate CSA measurements for each of the bilateral VNs with complete transducer removal between each measurement. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented. The mean CSA of the right VN in the carotid sheath was 2.1 and 1.9 mm2 for the left VN. The right VN CSA was significantly larger than the left VN (P < .012). No statistically significant correlation was noted in relation to height, weight, and age. We believe that the reference values for the normal CSA of the VN obtained in our study, could help in the sonographic evaluation of VN enlargement, as it relates to the diagnosis of various diseases affecting the VN.

Discussing sexuality with patients with neurological diseases: A survey among neurologists working in Saudi Arabia.

Background: Neurological diseases frequently affect sexual activity, and the resulting sexual dysfunction can cause much distress for patients. However, despite the importance of such complaints, neurologists frequently do not ask patients about their sexual symptoms or how their neurological illness and medications are affecting their sexual health. This study aimed to identify these difficulties as well as potential obstructions to conversations for addressing sexual dysfunction in patients with neurological diseases. Methods: This cross-sectional study was performed by sending invitation letters and questionnaires to registered neurologists in Saudi Arabia. The questionnaire was constructed to determine the possibility of discussing sexual activities and function with patients with neurological diseases and the possible obstacles neurologists face in this regard. Statistical analyses were performed using the Statistical Package of Social Sciences (SPSS) program version 25, and p-values of <0.05 were considered statistically significant. Results: A total of 258 of 750 neurologists (34.4%) returned the survey, of which 252 had completed the entire survey; therefore, their responses were considered suitable for further analysis. The majority of the respondents (63.1%) seldom discussed sexuality with their patients, more than half of the participants never discussed sexuality with female patients, and patients aged 60 years or older. The most commonly reported barriers were the lack of spontaneous communication by patients regarding their sexual problems (82.1%), insufficient consultation time (60.7%), and barriers based on language/culture/religion (53.6%). The majority of the respondents (61.9%) expressed the need for training on discussing sexuality as a measure that may enhance the discussion of sexual life with patients. Most of the respondents (92.9%) considered the patients responsible for bringing up problems in their sexual functioning during a patient interview. Conclusion: Sexual dysfunction is rarely discussed with patients showing neurological diseases, particularly with female patients. This is due to the patient's inability to articulate their sexual problems freely as well as a lack of consultation time. Training on discussing sexuality may enhance the discussion of sexual life with patients.