The effect of cardiovascular morbidity on clinical response provided by tadalafil in patients with erectile dysfunction

We aimed to investigate the association between erectile dysfunction and severity of cardiovascular morbidity and to assess clinical responses to tadalafil of patients in different cardiovascular risk groups. Between November 2019 and August 2020, a total of 258 male patients aged 45–70 years with ED were included. They were divided into three groups according to the Framingham risk score: low-risk (n: 86, 33.3%), intermediate-risk (n: 103, 39.9%) and high-risk (n: 69, 26.8%). At admission, all domains of the International Index of Erectile Function score were worse in high-risk group compared to other risk groups (p < .001). After a 12-week follow-up, a more significant improvement was observed in all domains of erectile function in all risk groups, but high-risk group had lower sexual scores (p < .001). The lowest rate for complete responsiveness to tadalafil was observed in the high-risk group (37.7%). The rate of failure in complete responsiveness was found to be 4.127 times greater with higher Framingham score and 3.102 times greater with higher erectile dysfunction severity at admission. Our preliminary findings show that more severe sexual disorders are observed in high-risk patients with cardiovascular morbidity. Individualised treatment may be important in high-risk group since they may benefit less from tadalafil, and failure in complete responsiveness can be more common in this group.     

Microsurgical versus endoscopic trans-sphenoidal approaches for clivus chordoma: a pooled and meta-analysis

Neurosurgical Review - Chordoma is a rare slow-growing neoplastic bone lesion. However, they show an invasive local growth and high recurrence rate, leading to an overall survival rate of 65% at 5...     

Interobserver variation in the diagnosis and grading of dyskaryosis in cervical smears: specialist cytopathologists compared with non-specialists.

AIMS--To compare the assessment of dyskaryosis in cervical smears made by specialist consultant cytopathologists and consultant general histopathologists. METHODS--One hundred and ten cervical smears were circulated to 10 observers from five district general hospital histopathology departments and five major departments of cytopathology. Their responses were analysed by five consultant general histopathologists and five consultant specialist cytopathologists. In 54 of the 110 cases, the histology of a corresponding cervical biopsy specimen was compared with the smear assessments. RESULTS--Specialist cytopathologists were more consistent than non-specialists when diagnosing and grading dyskaryosis. They chose the higher grades of dyskaryosis more frequently than the non-specialists. The cytopathologists recommended referral for colposcopy more frequently, but if they asked for a repeat smear, they wanted it done within three months more frequently than the histopathologists. The specialists were more frequently in agreement with the biopsy grade of intra-epithelial neoplasia than the non-specialists, whose smear diagnoses tended to underestimate the severity of the histopathological abnormality. CONCLUSIONS--This study has shown major differences between specialist and non-specialist cytopathologists in the diagnosis and grading of cervical smears and in the recommended management of patients with abnormal smears. These differences may result in uneven clinical management of women with smear abnormalities. It is therefore important to explore possible strategies for standardising the reporting of cervical smears, such as centralisation of screening services, accreditation in cytopathology for non-specialist consultants, and the value of participation in external quality assessment schemes.     

Congenital lens coloboma and associated pathologies

Coloboma of the lens is characterized by notching of the equator of the lens. The cause of the condition is faulty development of the zonule. The lens deprived of its normal pull in the defective region is thicker and more spherical as if there were no loss of its substance. We report five cases of lens coloboma and localized zonular defect without any associated systemic anomalies. One case included retinal detachment; another included an iris coloboma; and a third included iris, choroid and optic disk colobomas and retinal detachment with lens coloboma. The remaining two cases were without associated ocular anomalies. The pathogenic mechanisms and relationship of this defect with the differentiation of the tertiary vitreous and development of the zonule is discussed. The defect most likely occurs in the third to fourth months of gestation during differentiation of the tertiary vitreous in response to toxic, inflammatory or genetic factors.     

Synthesis of sulphonic acids and sultam derivatives

Reaction of propane-1,3-sultone with amines gave N-substituted aminosulphonic acids2a?i. Dehydration of2a?c with POCl₃ gave the corresponding sultams3a?c. Propane-1,3-sultone1 reacted with tertury amines to give the betaiene salts4–11. 2,4-Dimethyl-1,3-butadiene-1,4-sultone12 condensed with amines to give N-substituted-2,4-dimethyl-1,3-butadiene-1,4-sultams13a and13b. The reaction of3a, 13a with hydrazine hydrate gave acid hydrazides3d or13c. Compounds3d, 13c reacted with isocyanates to yield urea derivatives14a?c, 15a?c.     

Evaluation of BCG vaccination: an intervention study in Rail Region, Saudi Arabia

Inspection of 300 infants attending a primary health care (PHC) center at Hail region showed that 18.8% of children failed to develop BCG reations. This directed attention to inspect the process of vaccination at hospitals in which 80% of deliveries and BCG vaccination took place. Defects in the process of vaccination and cold chain system were noticed. Reorganization of the process of vaccination in addition to training the staff responsible for vaccination were done. A survey was followed to evaluate failure of BCG vaccination before and after the intervention. We checked 4145 infants two to twelve months of age, for any reaction at the site of BCG vaccination. After intervention vaccination failure dropped from 20.4% to 4.9% for infants vaccinated in hospitals (p = 0.00001), and from 7.9% to 3.2% for those vaccinated in health centers (p = 0.01). Moreover, before intervention success of BCG vaccination was significantly higher in PHC centers (92.1%) than in hospitals (79.6%). This difference became insignificant after intervention because success of BCG vaccination in hospitals has increased up to 95.1% compared to 96.8% in health centers. Inspection of all infants for BCG reaction is continued as a part of routine work at PHC centers, and re-vaccination of those who failed to develop reation to BCG is conducted without any reported complications.     

Antropometric measurements and body composition of English and Malaysian footballers

This comparative study was conducted to determine the anthropometric measurements and body composition of football teams in the UK and Malaysia. A total of 32 footballers from two teams were studied. The teams were the St Mary's University team (UK) and the Selangor Reserved League team. The height and body weight of the subjects were measured using SECA digital balance with height attachment. Skinfold thickness measurements were taken using Harpenden skinfold callipers at four sites (biceps, triceps, subscapular and suprailiac) and the VO2max of the subjects was estimated by participation in a multi-stage 20m shuttle-run test. The UK team were significantly heavier (p<0.05), taller (p<0.05) and had a higher body fat content (p<0.05) than their Malaysian counterpart. There was no significant difference in VO2 max between the two teams, with the Malaysians recording a slightly higher VO2 max. With regard to playing position, the defenders were found to be the most physically robust and yet had the highest VO2 max, whilst the midfielders had the lightest body weights. More data on the body composition and nutritional status of Malaysian footballers would allow adjustments to be made to dietary intakes and training levels in order to obtain maximum performance throughout the football season.     

Anthropometric measurements and body composition of selected national athletes

This study was conducted to determine the anthropometric measurements and body composition of selected national athletes. A total of 84 male athletes from 10 different types of sports and 24 female athletes from 5 types of sports were studied. The height and body weight of subjects were measured using the SEGA weighing balance with height attachment. Skinfold thickness measurements were taken using the Harpenden Calipers at 4 sites (biceps, triceps, subscapular and suprailiac). Percentage of body fat was calculated from the sum of 4 measurements of skinfold thickness. Based on body mass index (BMI), most of the male (68 subjects or 81%) and female (19 subjects or 79%) athletes were classified as normal. The percentage average body fat for both male and female athletes were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The male and female athletes also had lower percentage of body fat when compared to non-athletes, however these athletes had slightly higher percentage of body fat when compared to those in selected countries.     

Effect of isolation rearing on 5-HT agonist-induced responses in the rat

Rats were reared from weaning (21 days of age) either in isolation or in social groups of five for 30 days and were then tested for spontaneous locomotor activity and 7 days later for 5-hydroxytryptamine (5-HT) agonist-induced behaviour. Isolation-reared animals displayed locomotor hyperactivity when placed in a novel environment. 5-methoxy-N,N-dimethyltryptamine (5-MeODMT) (2 mg/kg IP) and 8-hydroxy-2-(di-n-propyl-amino) tetralin (8-OH-DPAT) (0.32 mg/kg SC) elicited various components of the 5-HT behavioural syndrome in both groups of animals, with forepaw treading and flat body posture being significantly more pronounced in isolation-reared animals. 1-(2,5-Dimethoxy-4-iodophenyl)-2-aminopropane (DOI) (2.5 mg/kg IP), a 5-HT₂ selective agonist, produced a significantly greater number of back muscle contractions in isolation-reared animals but there was no difference between the two groups in the number of wet-dog shakes produced. Forepaw treading and flat body posture are thought to be mediated by 5-HT_1A receptor activation, and stimulation of this receptor by either 5-MeODMT or 8-OH-DPAT produced greater responding in isolation-reared rats, suggesting supersensitivity of the post-synaptic 5-HT_1A receptor. Wet-dog shakes are thought to be mediated by 5-HT₂ and other (none-5-HT) receptors while back muscle contractions have been shown to be mediated by 5-HT₂ receptors, indicating that there is also an increase in 5-HT₂ receptor responsiveness in the socially-isolated animals. In general, the results indicate post-synaptic 5-HT receptor supersensitivity in isolation-reared rats and these receptor changes may be involved in the behavioural profile observed in such rats.