Effect of Tadalafil on Penile Duplex parameters in Erectile Dysfunction Patients

Background: Tadalafil is a PDE-5 (phosphodiesterase inhibitor) inhibitor that supports endogenous nitric oxide's vasodilatory actions and aids in erection maintenance. The penile duplex has proven to be very useful for imaging superficial structures and for determining the reasons of erectile dysfunction (ED). Objectives: To assess the effect of daily oral tadalafil 5mg for 3 months on penile duplex parameters in erectile dysfunction patients. Patients and Methods: A case control study involved 30 Egyptian patients ED. Appropriate clinical history and penile duplex examination before and after treatment with daily oral tadalafil mg for 3 months were performed. Results: The mean age of the patients was 53.17 ± 7.8 years. We founded that there was significant (p < 0.001) improvement in the level of erection after treatment. The rate of erection E1 and E2 was decreased from 53.3% to 3.3%. Likewise, the rate of E3-E5 was increased from 46.7% to 96.7%. Moreover, the mean duration of erection was elongated from 24.7 ± 5.3 to become 37.4 ± 3.8 and this was statistically significant (p < 0.001). Also, the mean peak systolic volume (PSV) was significantly (p = 0.001) increased after treatment (38.4 ± 9.1 cm/s) compared with the pre-treatment levels (23.9 ± 6.1 cm/s). Unlikely, the mean end diastolic volume (EDV) was insignificantly (p = 0.340) lower in post-treatment (2.25 ± 0.5 mL) compared with pre-treatment levels (2.97 ± 0.4 mL). Likely, the mean resistant index (RI) showed insignificant difference (p = 0.965) after treatment (0.9 ± 0.02) compared with before treatment (0.9 ± 0.08). For penile artery diameter, there was significant (p = 0.009) increase in the diameter after treatment (0.9 ± 0.1 mm) compared with before treatment (0.8 ± 0.1 mm). Conclusion: Oral daily tadalafil 5mg for 3 months is considered an effective treatment for ED according to penile duplex parameters

Isolation, Identification, and In Vitro Antifungal Susceptibility Testing of Dermatophytes from Clinical Samples at Sohag University Hospital in Egypt

Aim: The objective of this study was to isolate, identify, and explore the in-vitro antifungal susceptibility pattern of dermatophytes isolated from clinically suspected cases of dermatophytosis (tinea infections) attending the Dermatology Outpatient Clinic. Methods: This study was conducted at Sohag University Hospital from December 2014 to December 2015. Clinical samples (e.g., skin scrapings and hair stumps) were collected under aseptic precautions. The identification of dermatophytes was performed through microscopic examination using 10% potassium hydroxide (KOH) with 40% dimethyl sulphoxide (DMSO) mounts and culture on Sabouraud dextrose agar (SDA) and on Dermasel agar base media, both supplemented with chloramphenicol and cycloheximide. All dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion (ABDD) method against Clotrimazole, Miconazole, Fluconazole, and Griseofulvin. Data were analyzed via SPSS 16, using Chi square and a screening test (cross-tabulation method). Results: A total of 110 patients of dermatophytosis were studied. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis (49), tinea corporis (30), tinea pedis (16), tinea cruris (9), or tinea barbae (6). The dermatophytes isolates belonged to 4 species: Microsporum canis 58 (52.7%), Microsporum gypseum 23 (20.9%), Trichophyton mentagrophytes 18 (16.4%), and Microsporum audouinii 11 (10%). The most effective antifungal drugs tested were Clotrimazole, followed by Miconazole (95.5% and 84.5% of isolates were susceptible, respectively). Conclusion: Every patient with a tinea infection should be properly studied for a mycological examination and should be treated accordingly. Dermasel agar is more useful as an identification medium in the isolation of dermatophytes. The ABDD method appears to be a simple, cost-effective, and promising method for the evaluation of antifungal susceptibility of dermatophytes