Trends, safety, and efficacy of wearable male sexual devices.

INTRODUCTION: The prevalence of male sexual dysfunction (MSD) increases with age, with >50% of men aged >40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been increasingly utilized by patients and recommended by sexual medicine clinicians. OBJECTIVES: This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. METHODS: Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were based on patient reviews, cost, and specific features. Investigatory evidence and Food and Drug Administration status were also reviewed. Additionally, Google Trends was used to determine the popularity of devices over time. RESULTS: Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the RigiScan, the Adam sensor provides feedback on erectile quality while monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices such as the Morari Patch and vPatch/in2 Patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. CONCLUSIONS: Overall, this review describes the available investigatory evidence for a range of WMSDs and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients.

o-Vanillin Derived Schiff Bases and Their Organotin(IV) Compounds: Synthesis, Structural Characterisation, In-Silico Studies and Cytotoxicity.

Six new organotin(IV) compounds of Schiff bases derived from S-R-dithiocarbazate [R = benzyl (B), 2- or 4-methylbenzyl (2M and 4M, respectively)] condensed with 2-hydroxy-3-methoxybenzaldehyde (oVa) were synthesised and characterised by elemental analysis, various spectroscopic techniques including infrared, UV-vis, multinuclear (¹H, 13C, 119Sn) NMR and mass spectrometry, and single crystal X-ray diffraction. The organotin(IV) compounds were synthesised from the reaction of Ph2SnCl2 or Me2SnCl2 with the Schiff bases (S2MoVaH/S4MoVaH/SBoVaH) to form a total of six new organotin(IV) compounds that had a general formula of [R2Sn(L)] (where L = Schiff base; R = Ph or Me). The molecular geometries of Me2Sn(S2MoVa), Me2Sn(S4MoVa) and Me2Sn(SBoVa) were established by X-ray crystallography and verified using density functional theory calculations. Interestingly, each experimental structure contained two independent but chemically similar molecules in the crystallographic asymmetric unit. The coordination geometry for each molecule was defined by thiolate-sulphur, phenoxide-oxygen and imine-nitrogen atoms derived from a dinegative, tridentate dithiocarbazate ligand with the remaining positions occupied by the methyl-carbon atoms of the organo groups. In each case, the resulting five-coordinate C2NOS geometry was almost exactly intermediate between ideal trigonal-bipyramidal and square-pyramidal geometries. The cytotoxic activities of the Schiff bases and organotin(IV) compounds were investigated against EJ-28 and RT-112 (bladder), HT29 (colon), U87 and SJ-G2 (glioblastoma), MCF-7 (breast) A2780 (ovarian), H460 (lung), A431 (skin), DU145 (prostate), BE2-C (neuroblastoma) and MIA (pancreatic) cancer cell lines and one normal breast cell line (MCF-10A). Diphenyltin(IV) compounds exhibited greater potency than either the Schiff bases or the respective dimethyltin(IV) compounds. Mechanistic studies on the action of these compounds against bladder cancer cells revealed that they induced the production of reactive oxygen species (ROS). The bladder cancer cells were apoptotic after 24 h post-treatment with the diphenyltin(IV) compounds. The interactions of the organotin(IV) compounds with calf thymus DNA (CT-DNA) were experimentally explored using UV-vis absorption spectroscopy. This study revealed that the organotin(IV) compounds have strong DNA binding affinity, verified via molecular docking simulations, which suggests that these organotin(IV) compounds interact with DNA via groove-binding interactions.

Psychometric Evaluation of the Brunei-Malay SF-36 version 2 Health Survey

Objectives: To culturally adapt the Short Form Health-36 version 2 (SF-36v2) into the Brunei-Malay context and determine its reliability and validity for measuring health-related quality of life (HRQOL) in healthy individuals and patients with chronic kidney disease in Brunei Darussalam. Methods: An iterative multistep strategy involving setting up a bilingual expert panel, pretesting, text revision and back translation was used to prepare the Brunei-Malay SF-36v2 as an adaptation from the Malaysian-Malay SF-36v2. The Brunei-Malay SF-36v2 was then self-administered to a sample of healthy individuals (n=95) and predialysis chronic kidney disease outpatients (n=95) resident in Brunei. The mean (SD) age of the participants was 46.6 (17.8) years. Results: Data completion rate was 100% with minimal floor effects (≤0.21) in all the 8 domains and >15% ceiling effects in 3 of the 8 domain scales. Cronbach's alpha was >0.70 for all the 8 domain scales. Scaling success was 100% for convergent validity, with 100% item discriminant validity for all domain scales except Social Functioning (94%), Mental Health (85%) and General Health (85%). Principal component analysis of the two-factor dimension explained 68% overall variance and accounted for 81% reliable variance, but the exact SF-36 two-factor summary constructs in the standard algorithm were not replicated in the Bruneian population. Conclusions: The Brunei-Malay SF-36v2 is a valid and reliable instrument for measuring HRQOL in healthy individuals and patients with chronic kidney disease in Brunei. The summary scales should, however, be interpreted with caution. Further studies should be carried out to assess additional psychometric properties of the Brunei-Malay SF-36v2.

Modeling stability and flexibility of α-Chymotrypsin in room temperature ionic liquids.

We investigate the structure and dynamics of α-Chymotrypsin in five room temperature ionic liquids (RTILs) sharing a common cation, hydrated with different water percentages (w/w) (weight of water over protein). Results from molecular dynamics simulations are correlated with experimental evidences from studies on the activity of enzymes in RTILs. α-Chymotrypsin protein structure is closer to its native crystallographic structure in RTILs than in aqueous environment. We show that the structural properties of α-Chymotrypsin were affected by the water concentration assayed in a typical bell-shaped profile, which is also frequently reported for organic solvents. The protein structure was more native like at 10-20% of water (w/w) for all RTILs except for [BMIM][Cl]. We found that the fluctuations of the main chain in [BMIM][BF4] and [BMIM][TfO] were not significantly affected by the increasing amount of water. However, we were able to show that the flexible regions were the ones more hydrated, indicating that water is responsible for the flexibility of the protein. The solvation of the enzyme in water-immiscible RTILs, such as [BMIM][PF6] and [BMIM][Tf2N] lead to higher enzyme flexibility at increased water content. Enzyme solvation by [BMIM][Cl] resulted in ion penetration in the core enzyme structure, causing incremented flexibility and destabilization at low water percentages. All RTILs stripped water molecules from the protein surface, following a similar behavior also found in organic solvents. Anions formed structured arrangements around the protein, which allowed non-stripped water molecules to localize on the protein surface.

Acute kidney injury in dengue virus infection.

BACKGROUND: Dengue is a growing public health problem in Pakistan and acute kidney injury (AKI) is one of the least studied complications of dengue virus infection (DVI). The aim of this study was to determine the frequency, severity and predictors of AKI in patients with DVI and to study the impact of AKI on the length of hospital stay and mortality. METHODS: We retrospectively reviewed medical records of patients aged ≥14 years hospitalized with a primary diagnosis of DVI at Aga Khan University Hospital Karachi between January 2008 and December 2010. Binary logistic regression models were constructed to identify factors associated with the development of AKI and to study the impact of AKI on hospital stays of more than 3 days. RESULTS: Out of 532 patients, AKI was present in 13.3% (71/532). Approximately two-thirds (64.8%) of these patients had mild AKI and a third (35.2%) had moderate to severe AKI. Independent predictors for AKI were male gender [odds ratio (OD) 4.43; 95% CI 1.92-10.23], presence of dengue hemorrhagic and dengue shock syndrome (DSS, OD 2.14; 95% CI 1.06-4.32), neurological involvement (OD 12.08; 95% CI 2.82-51.77) and prolonged activated partial thromboplastin time (aPTT, OD 1.81; 95% CI 1.003-3.26). AKI was associated with a length of stay ≥3 days when compared with those who did not have AKI (OD 2.98; 95% CI 1.66-5.34). Eight patients (11.3%) with AKI died whereas there were no mortalities in patients without AKI (P < 0.001). Only 5 patients (7%) had persistent kidney dysfunction at discharge. CONCLUSIONS: AKI in DVI is associated with neurological involvement, prolongation of aPTT, greater length of hospital stay and increased mortality.

A combination therapy with copper nicotinate complex reduces the adverse effects of 5-fluorouracil on patients with hepatocellular carcinoma.

5-Fluorouracil (5-FU) as chemotherapy in cases of hepatocellular carcinoma (HCC), was found to initiate hepatotoxic injuries, ascites, leucopenia, thrombocytopenia and myelosupression that limit its use. Therefore, this work was conducted to investigate whether the combination of copper (I)-nicotinate complex [CuCl (HNA)2] with 5-FU may overcome such a drug resistance. Forty-eight patients with HCC were therapy-naïve and treated with 5-FU (12 mg/kg/day) for 5 days in 2 cycles with 4 weeks in between. Twenty-four of them were simultaneously given oral doses of copper (I)-nicotinate complex (0.8 mg/kg/day) started with the 5-FU treatment. The combined therapy of CuCl (HNA)2 with 5-FU could improve the prognosis of HCC-patients. Improvement of liver function was presented by significant reduction of serum bilirubin (p<0.001), transaminases and alkaline phoshatase (p<0.05). The copper complex prevented hypoproteinaemic and hypoalbuminaemic effects of 5-FU and rendered the prothrombin time to its normal value (p<0.001). Superoxide dismutase, ceruloplasmin and immunoglobulins IgG showed significant increases (p<0.001), while serum copper and lipid peroxides were reduced (p<0.001). Thrombocytopenia, leucopenia and other myelosuppressive effects of 5-FU were reduced by the co-administration of CuCl (HNA)2. In conclusion the combination with CuCl (HNA)2 given in such a dosage schedule mitigated the most frequent toxicities associating 5-FU administration and enhanced defense mechanisms against oxidative stress.

A bradykinin potentiating peptide from Egyptian cobra venom strongly affects rat atrium contractile force and cellular calcium regulation.

Peptide fractions were isolated from venoms of the Egyptian snake Naja haje haje (cobra BPP) and the scorpions Buthus occitanus (BPP(B)) and Leirus quenquestriatus (BPP(L)). The pharmacological effects of these peptides were bioassayed and showed bradykinin potentiating activities. Amino acid analysis revealed that 14 amino acids contribute to the structure of BPP(B) and 16 for BPP(L), while cobra BPP was composed of 15 amino acids. Treatment of rat atrial preparations with 50 microg/ml of cobra BPP caused a significant reduction (P<0.001) in myocardial force. Elevation of extracellular calcium concentration from 1.25 to 5 mM antagonized the effect of cobra BPP in a way that restored the atrial force development. Na(+)-channel blockers did not change the force development at 5 mM Ca(2+). Experiments with (45)Ca revealed that Ca(2+) uptake of cobra BPP treated atria was 0.52+/-0.07 microM/g wet mass and the force at the end of the uptake period was 55.0+/-2.0%. The corresponding values for non-treated preparations were 0.56+/-0.04 microM/g and 92.0%+/-3.0%, respectively. Our results revealed that cobra BPP did not exhibit any effect on Ca(2+) uptake by rat atrial preparations, but strongly affected cellular Ca(2+) regulation.

Renal dysfunction in liver cirrhosis: renal duplex Doppler US vs. scintigraphy for early identification.

A diagnostic tool to detect early renal dysfunction before it becomes irreversible would be useful in cirrhosis. This study was carried out to evaluate the role of Doppler sonography and Tc-99m DTPA renography in the detection of early renal dysfunction in patients with different grades of liver cirrhosis. Renal arteries of 43 patients with cirrhosis and normal renal function tests were compared with 15 age and gender matched normal subjects as a control group using colour Doppler sonography and Tc-99m DTPA scintigraphy. The patients were categorized into three groups, A (14), B (14) and C (15), according to a modified Child's classification that assesses the severity of liver cirrhosis. Doppler results revealed a highly significant increase in both the pulsatility and resistive indices in groups B and C compared with either group A patients or control subjects and in group C compared with group B (P < 0.001) in the main renal arteries as well as in the interlobar and arcuate arteries. Insignificant differences were observed between group A and controls (PI: control 0.96+/-0.08, group A 0.95+/-0.07, group B 1.26+/-0.06, group C 1.48+/-0.06; RI: control 0.57+/-0.02, group A 0.58+/-0.02, group B 0.66+/-0.01, group C 0.72+/-0.02). Abnormal renograms in the form of delayed appearance (34+/-14.6 s), diminished blood flow bilaterally with prolonged secretory (12+/-4.5 min) and excretory phases (> 30 min) and poor response to intravenous frusemide were only observed in group C patients. Radionuclide computed glomerular filtration rate was within the normal range in patients of group A (81+/-9.5 ml/min) and group B (78+/-8.4 ml/min) and reduced only in patients of group C (34+/-14.5 ml/min). Thus Doppler sonography can detect an increase in renal vascular resistance in patients with moderately severe cirrhosis (Child grade B) when renography was normal. We conclude that Doppler sonography can be used for earlier identification of cirrhotic patients with a higher risk of impending renal failure earlier than renography and may also be used to guide therapeutic approaches.

Studies on faecal streptococci in the river Tigris.

Six hundred water samples collected from the river Tigris at Mosul City were investigated for faecal streptococci. Human faecal streptococci were predominant, and animal faecal streptococci were also detected. Eight species and varieties were identified, viz Streptococcus faecalis, atypical Streptococcus faecalis, Streptococcus bovis, Streptococcus equinus, Streptococcus faecalis var. liquefaciens, Streptococcus faecalis var. zymogenes, Streptococcus durans and Streptococcus faecium. The incidence of these species and varieties were 43.32%, 13.18%, 11.47%, 11.30%, 9.76%, 5.30%, 3.76% and 1.88%, respectively.