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INTRODUCTION: Methadone maintenance treatment (MMT) is a popular method of treating opioid use disorder. However, the majority of drug-using males experience sexual dysfunction. OBJECTIVES: This systematic review and meta-analysis examined the possible impact of MMT on sexual dysfunction in drug-using males. METHODS: Cochrane, Web of Science, ProQuest, PubMed, and Google Scholar are the international databases that we used in this study. There were neither temporal nor regional limitations on the search. Stata version 14 (StataCorp) was used for data analysis. RESULTS: When compared with the control group, the MMT group, as measured by the International Index of Erectile Function (IIEF), exhibited significantly greater levels of intercourse satisfaction disorders (standardized mean difference [SMD], -0.52; 95% CI, -0.71 to -0.32), decreased sexual desire/drive (SMD, -0.44; 95% CI, -0.87 to -0.01), lower overall satisfaction (SMD, -0.27; 95% CI, -0.43 to -0.11), and reduced total IIEF score (SMD, -0.69; 95% CI, -0.92 to -0.47). According to the Arizona Sexual Experiences Scale, the MMT group was substantially more satisfied with orgasm than the control group (SMD, 0.58; 95% CI, 0.31-0.86). As determined by the Sexual History Form, MMT was linked to a statistically significant increase in orgasmic dysfunction in comparison with the control group (SMD, 0.65; 95% CI, 0.10-1.20). The Arizona Sexual Experiences Scale revealed a significant decrease in men reporting sexual disorder following MMT as compared with their pretreatment levels. CONCLUSION: As compared with control, MMT increased disorders of intercourse satisfaction, sexual desire/drive, and overall satisfaction according to the IIEF. MMT was also associated with a statistically significant decrease in various aspects of male sexual function as compared with pretreatment levels-including erectile function, intercourse satisfaction, orgasmic function, sexual desire/drive, and overall satisfaction. These findings highlight the importance of including sexual dysfunction screening in the routine care of male patients undergoing MMT.
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Background: The hypo-perfusion of the kidneys can lead to impairment in renal function and induce renal injury in case of delayed diagnosis and treatment. To date, laboratory markers are routinely used to determine the fluid volume status of the patients. The current study aims to evaluate the values of inferior vena cava (IVC) collapsibility index in hypovolemia diagnosis among critical patients admitted at the intensive care unit (ICU). Materials and Methods: This is a cross-sectional study performed on 67 patients admitted to the ICU due to acute kidney injury from May 2018 to October 2019. Hypovolemia was assessed assessing IVC collapsibility using ultrasonography. Laboratory data, including urine osmolality, urine-plasma creatinine ratio, sodium excretion fraction and urinary sodium level were checked. Afterward, IVC collapsibility index was measured for each patient using ultrasonography and the values of this index in accordance with the mentioned criteria was evaluated. Accordingly, reciever operating curve was depicted. Results: There was no significant asosociation between IVC collapsibility index with fractional excretion of sodium (P = 0.69), urine Na (P = 0.93) and urine osmolality ([P = 0.09]), while urine: Plasma creatinie ration revealed a significant association with IVC collapsibility index at cut point of 40.5% with sensitivity and specificity of 96% and 44% (P = 0.017, area under the curve: 0.67, 95% confidence interval: 0.551-0.804), respectively. Conclusion: According to the findings of this study, IVC collapsibility detected via ultrasonography was not an appropriate index to figure out hypovolemia in ICU patients. Furthermore, detailed studies are recommended.
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OBJECTIVE: To determine the relationship between elevated liver enzymes with iron overload and viral hepatitis in thalassemic patients. METHODS: This descriptive cross-sectional study was carried out in the thalassemic ward of Tonekabon Hospital, Mazandaran, Northern Iran from 20 April to 20 September of 2006. Patients were studied with respect to age, liver enzymes, anti-hepatitis C virus (anti-HCV) antibody, and hepatitis B surface antigen (HBsAg), transferrin saturation (TSAT), and blood transfusion index (multiplication of frequency and units of transfusion). Alanine aminotransferase (ALT) > or =40 U/L was considered elevated. RESULTS: Sixty-five patients were evaluated (median age 19.51+/-8.9 years, range 4-54). Eleven patients were anti-HCV positive (16.9%). The mean serum ferritin was significantly higher in patients with ALT > or =40 (2553.08 ug/L versus 1783.7750 microg/L) (p=0.012). The mean ALT was significantly higher in patients with TSAT > or = 60% (41.26 U/L versus 28.82 U/L) (p=0.021). The relationship between ALT > or =40 and anti-HCV positivity was statistically significant. The mean ALT was 60.91 U/L in anti-HCV positive patients and 39.29 U/L in the negative group (p=0.001). The mean serum iron and transfusion index were significantly higher in anti-HCV positive versus negative patients (234.0 versus 195.4815; p=0.02), (1693.6 versus 1036.29, p=0.014). CONCLUSION: Close association between elevated ALT with iron overload, transfusion index, age, and anti-HCV positivity in thalassemic patients of Tonekabon is recommended to re-evaluate transfusion and Desferal doses and therapies other than blood transfusion.
