Study of risk factors for erectile dysfunction in patients with type 2 diabetes mellitus: Correlation to serum testosterone level

Background: Diabetes mellitus (DM) is one of the most frequent etiologies of erectile dysfunction (ED). Risk factors of ED in type 2 diabetes mellitus (T2 DM) include patient age, disease duration, sedentary life and glycemic control. Subnormal testosterone concentrations contribute to ED as testosterone regulatesnearly every component of erectile function.The aim of the work was to study the age of the patient, duration of diabetes mellitus, body mass index (BMI), glycosylated hemoglobin (HbAIc) and urinary albumin creatinine ratio (uACR) in type 2 male diabetic patients as risk factors for erectile dysfunction and their relation to serum testosterone level.Patients and methods: This study was conducted on 100 male type 2 diabetics selected from inpatient department and out patient clinics of the Internal Medicine Department in Menoufia University Hospital. The patients were divided into two groups: Group 1: 50 patients with type 2 DM with erectile dysfunction and Group 2: 50 patientswith type 2 DMwithout erectile dysfunction. The study groups were subjected to thorough history with special emphasis on age of the patients, disease duration and investigations including testosterone level, glycosylated hemoglobin, and uACR. The patients answered the abridged 5-item version of the International Index of Eectile Function (IIEF-5) questionnaire.Results: Total serum testosterone was significantly lower in diabetics with ED compared to those without ED. HbAIc, diabetes duration and uACR were independently negatively correlated with testosterone level.Conclusion: The diabetes duration, glycemic control and uACR contribute to erectile dysfunction in type 2 diabetics, and they were independently and negatively correlated with total serum testosterone level.Keywords: Type 2 diabetes mellitus, Erectile dysfunction, Serum testosteron

Diabetes Mellitus Prevalence and Burden among Community Acquired Pneumonia Patients

This work aimed at measuring the prevalence of Diabetes Mellitus among community acquired pneumonia (CAP) patients and declaring its effect on CAP patient's outcome. Both community acquired pneumonia and diabetes mellitus are common in Egypt, and patients with associated CAP and DM need special care and supervision. This   prospective study was carried out on 108 CAP patients admitted to Abassia Chest Hospital during the period from January 2016 to December 2016. Clinical and radiological diagnosis of pneumonia and DM diagnosis were performed. DM recorded a prevalence of 39.8% among community acquired pneumonia patients. Disturbed level of consciousness is more frequent among diabetic patients than non diabetics. Diabetic patients recorded higher rate of hospital admission, longer duration of hospital stay, higher rate of ICU admission and more sever pneumonia than among non diabetic patients. CURB-65 score showed significant positive correlation with HbA1c of the patients. Associated community-acquired pneumonia and diabetes mellitus is frequent in our locality and labor a double burden on the affected patients leading to poorer prognosis, higher rate of hospitalization with longer duration of hospital stay and ICU admission. So CAP patients with DM need intimate care

Effectiveness of third-class biologic treatment in Crohn's disease : a multi-center retrospective cohort study

C

Effectiveness of third-class biologic treatment in crohn’s disease : A multi-center retrospective cohort study

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Background: Multiple studies have described the effectiveness of ustekinumab (UST) and vedolizumab (VDZ) in patients with Crohn’s disease (CD) failing anti-Tumor necrosis factors (TNFs); however, the effectiveness of VDZ or UST as a third-class biologic has not yet been described. Aims and Methods: In this retrospective multicenter cohort study, we aimed to investigate the effectiveness of VDZ and UST as a third-class biologic in patients with CD. Results: Two-hundred and four patients were included; 156/204 (76%) patients received VDZ as a second-and UST as a third-class therapy (group A); the remaining 48/204 (24%) patients received UST as a second-and VDZ as a third-class therapy (group B). At week 16–22, 87/156 (55.5%) patients and 27/48 (56.2%) in groups A and B, respectively, responded to treatment (p = 0.9); 41/156 (26.2%) and 15/48 (31.2%) were in clinical remission (p = 0.5). At week 52; 89/103 (86%) patients and 25/29 (86.2%) of the patients with available data had responded to third-class treatment in groups A and B, respectively (p = 0.9); 31/103 (30%) and 47/29 (24.1%) were in clinical remission (p = 0.5). Conclusion: Third-class biological therapy was effective in more than half of the patients with CD. No differences in effectiveness were detected between the use of VDZ and UST as a third-class agent.Peer reviewe

Diabetes Mellitus Prevalence and Burden among Community Acquired Pneumonia Patients

This work aimed at measuring the prevalence of Diabetes Mellitus among community acquired pneumonia (CAP) patients and declaring its effect on CAP patient's outcome. Both community acquired pneumonia and diabetes mellitus are common in Egypt, and patients with associated CAP and DM need special care and supervision. This   prospective study was carried out on 108 CAP patients admitted to Abassia Chest Hospital during the period from January 2016 to December 2016. Clinical and radiological diagnosis of pneumonia and DM diagnosis were performed. DM recorded a prevalence of 39.8% among community acquired pneumonia patients. Disturbed level of consciousness is more frequent among diabetic patients than non diabetics. Diabetic patients recorded higher rate of hospital admission, longer duration of hospital stay, higher rate of ICU admission and more sever pneumonia than among non diabetic patients. CURB-65 score showed significant positive correlation with HbA1c of the patients. Associated community-acquired pneumonia and diabetes mellitus is frequent in our locality and labor a double burden on the affected patients leading to poorer prognosis, higher rate of hospitalization with longer duration of hospital stay and ICU admission. So CAP patients with DM need intimate care

Impact of mode of anesthesia on ischemia modified albumin, operative conditions, and outcome in emergency craniotomies

ABSTRACTBackground In neurosurgical procedures, selection of anesthetic techniques can have a substantial role in neurological outcome. Ischemia modified albumin (IMA) is a promising biomarker in strokes either hemorrhagic or ischemic. This work tried to explore the impact of type of the used anesthetics on operative condition, outcome, and if it can affect the level of IMA after emergency craniotomies.Methodology Fifty-four patients, 18–69 years of either sex, GCS>8, who underwent emergency craniotomies were enrolled into two groups where anesthesia was maintained by either: isoflurane ≤ 1Mac + fentanyl 1 mcg/kg/h. (Group I (inhalational)) or propofol infusion (100–150 mcg/kg/min) + dexmedetomedine 0.3mcg/kg/h. (Group P (TIVA)). Intraoperative hemodynamics, ICP, brain relaxation score, blood loose, and surgeon satisfaction were assessed. Also, recovery conditions, ICU stay, any complication and mortality, pre- and postoperative IMA and GCS were followed and analyzed.Results Group (P) revealed lower but steadier hemodynamics, significantly better brain relaxation score, lower ICP, adequate CPP, fewer patients needed blood transfusion, better surgeon satisfaction, and significantly shorter extubation time with higher sedation. Elevation in postoperative IMA was reported in both groups but the times of increase were significantly lower in group (P) with significant correlation between IMA level and GCS at all times that were detected in both groups. The two groups were comparable regarding postoperative complications, GCS, mortality, and ICU stay.Conclusion In emergency craniotomies, the use of TIVA (propofol + dexometomidine) produced lower ICP, better brain relaxation, and shorter extubation time with lower postoperative IMA level than inhalational anesthetics, which correlate well with GCS

Effectiveness of Third-Class Biologic Treatment in Crohn's Disease

Multiple studies have described the effectiveness of ustekinumab (UST) and vedolizumab (VDZ) in patients with Crohn's disease (CD) failing anti- Tumor necrosis factors (TNFs); however, the effectiveness of VDZ or UST as a third-class biologic has not yet been described.In this retrospective multicenter cohort study, we aimed to investigate the effectiveness of VDZ and UST as a third-class biologic in patients with CD.Two-hundred and four patients were included; 156/204 (76%) patients received VDZ as a second- and UST as a third-class therapy (group A); the remaining 48/204 (24%) patients received UST as a second- and VDZ as a third-class therapy (group B). At week 16-22, 87/156 (55.5%) patients and 27/48 (56.2%) in groups A and B, respectively, responded to treatment (p = 0.9); 41/156 (26.2%) and 15/48 (31.2%) were in clinical remission (p = 0.5). At week 52; 89/103 (86%) patients and 25/29 (86.2%) of the patients with available data had responded to third-class treatment in groups A and B, respectively (p = 0.9); 31/103 (30%) and 47/29 (24.1%) were in clinical remission (p = 0.5).Third-class biological therapy was effective in more than half of the patients with CD. No differences in effectiveness were detected between the use of VDZ and UST as a third-class agent

Effectiveness of Third-Class Biologic Treatment in Crohn’s Disease: A Multi-Center Retrospective Cohort Study

Background: Multiple studies have described the effectiveness of ustekinumab (UST) and vedolizumab (VDZ) in patients with Crohn’s disease (CD) failing anti- Tumor necrosis factors (TNFs); however, the effectiveness of VDZ or UST as a third-class biologic has not yet been described. Aims and Methods: In this retrospective multicenter cohort study, we aimed to investigate the effectiveness of VDZ and UST as a third-class biologic in patients with CD. Results: Two-hundred and four patients were included; 156/204 (76%) patients received VDZ as a second- and UST as a third-class therapy (group A); the remaining 48/204 (24%) patients received UST as a second- and VDZ as a third-class therapy (group B). At week 16–22, 87/156 (55.5%) patients and 27/48 (56.2%) in groups A and B, respectively, responded to treatment (p = 0.9); 41/156 (26.2%) and 15/48 (31.2%) were in clinical remission (p = 0.5). At week 52; 89/103 (86%) patients and 25/29 (86.2%) of the patients with available data had responded to third-class treatment in groups A and B, respectively (p = 0.9); 31/103 (30%) and 47/29 (24.1%) were in clinical remission (p = 0.5). Conclusion: Third-class biological therapy was effective in more than half of the patients with CD. No differences in effectiveness were detected between the use of VDZ and UST as a third-class agent