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Background: Affected sexual relationships affect both the quality of life of men and women. Platelet-derived therapies are becoming increasingly popular in various medical and surgical fields because of their ability to aid in tissue healing and vascular remodeling. This study aimed to assess the safety and effectiveness of platelet-rich plasma (PRP) injections in treating patients with erectile dysfunction (ED)., Results: Fifty-two participants with mild to moderate ED were divided into two groups: group A, who received three PRP penile injections, and group B, who received three saline injections (5 ml for each injection site). The International Index of Erectile Function (IIEF) was used to evaluate all participants. A month after the last injection, the PRP group's IIEF was 16.12 ± 1.25, while the placebo group's was 15.99 ± 1.21 (p = 0.683). Following a 3-month period, the IIEF for the PRP group was 16.44 ± 1.17, while the placebo group's was 16.31 ± 1.06 (p value = 0.653). Following a 6-month period, the IIEF for the PRP group was 16.35 ± 1.45, while that for the placebo group's was 16.23 ± 1.19 (p = 0.727). In terms of IIEF, there was no significant difference between the two groups after one, three, and six months of treatment., Conclusion: In brief, our research revealed no data to support the application of PRP injections in the management of mild-to-moderate ED., (© 2024. The Author(s).)

Objectives: Assessment of the relationship between dietary patterns and menstrual disorders among female medical and paramedical students at Beni-Suef University, Egypt., Methods: Beni-Suef University conducted a cross-sectional analytical questionnaire-based study. Three hundred fifty two female medical and paramedical students agreed to participate in the study. The collected data about demographics, physical activity, menstrual history, and dietary assessment were transferred to SPSS version 26 for statistical analysis. A p value ≤0.05 was considered statistically significant., Results: The prevalence of irregular cycles, heavy blood flow, severe dysmenorrhea, and premenstrual syndrome (PMS) was found to be (21.9 %), (13.1 %), (35.5 %), and (68.9 %), respectively. Poor adherence to the Mediterranean diet (40.1 %) and physical activity (69.9 %) was present. Females with irregular cycles (p=0.472), heavy menstrual blood flow (p=0.007), and severe dysmenorrhea (p=0.029) reported lower adherence to the Mediterranean diet. Mothers' educational level (p=0.034), family income (p=0.005), and family size (p=0.009) were significantly associated with dietary adherence., Conclusions: Poor adherence to regular physical activity and the Mediterranean diet is highly prevalent in our research and is highly associated with menstruation disorders. So, it is critical to support health education programs emphasizing healthy dietary habits and regular physical activity to improve menstrual health and women's quality of life., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

The purpose of this research was to examine the potential effects of bentonite (BN) supplemented diets on growth, feed utilization, blood biochemistry, and histomorphology of Dicentrarchus labrax. Six treatments in triplicate were tested: B0, B0.5, B1.0, B1.5, B3.0, and B4.5, which represented fish groups fed diets supplemented with 0, 0.5, 1, 1.5, 3, and 4.5% BN, respectively. For 84 days, juveniles' seabass (initial weight = 32.73 g) were fed diets containing 46% protein, three times daily at 3% of body weight. With a 5% daily water exchange, underground seawater (32 ppt) was used. Findings revealed significant improvements in water quality (TAN and NH3), growth (FW, WG and SGR) and feed utilization (FCR, PER and PPV) in fish fed BN-supplemented diets, with the best values in favor of the B1.5 group. Additional enhancements in kidney function indicators (urea and uric acid) and liver enzymes were observed in fish of the BN-treated groups along with a decrease in cholesterol level in the B1.5 group. Further improvements in fish innate immunity (hemoglobin, red blood cells, glucose, total protein, globulin, and immunoglobulin IgM), antioxidant activity (total antioxidative capacity and catalase), and decreased cortisol levels in fish of the BN-treated groups. Histological examinations of the anterior and posterior intestines and liver in groups B1.5 and B3 revealed the healthiest organs. This study recommends BN at a concentration of 1.5% as a feed additive in the Dicentrarchus labrax diet., (© 2024. The Author(s).)

Objective: To compare the efficacy of Holmium laser lithotripsy with that of extracorporeal shock lithotripsy (SWL) for post-SWL ureteral steinstrasse., Materials and Methods: From January 2022 to July 2023, 36 patients with post-SWL ureteral steinstrasse were randomly divided into laser lithotripsy and SWL groups. Patients with pain, moderate to marked hydronephrosis, large leading stone fragments, and showing no spontaneous resolution within 3-4 weeks after medical expulsive therapy were included. Patients with sepsis were excluded. The success rate was the primary outcome. We compared the perioperative data between the groups., Results: The success rate was higher in the ureteroscopy group than in the SWL group (p = 0.034). SWL was a significantly longer operation, and the fluoroscopy time was significantly longer in the SWL group than in the URS group (p = 0.027). Auxiliary procedures were more frequently performed in the SWL group than in the URS group (p = 0.02). JJ stents were inserted in 100% of patients in the URS group. Three patients (16.7%) underwent conversion to laser ureteroscopy after the second SWL session failed. No significant difference in the incidence of postoperative complications was observed between the groups, but the incidence of postoperative LUT was high in the ureteroscopy group. The mean hospital stay was 30 h in the ureteroscopy group. SWL was performed without the need for hospital admission., Conclusion: Ureteroscopic laser lithotripsy for steinstrasse was safe and effective, with a higher success rate, shorter fluoroscopy time, and shorter recovery period than SWL., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To evaluate medical students' knowledge, attitudes, and self-medication practices for acne vulgaris., Methods: An analytical cross-sectional study was conducted at Beni-Suef University's Faculty of Medicine from January 2023 to June 2023. A pre-structured questionnaire was used for the study., Results: A total of 297 students (85.1 %) used self-medications for acne without a prescription. The total knowledge score of self-medication among the study participants was 3.81 ± 2.23. About 71.4 % knew about precautions, and 72.7 % of the participants reported that self-medication is part of self-care. There was a statistical significance between the total mean knowledge score and age (p=0.007), gender (p=0.013), and academic year (p=0.001)., Conclusions: A significant portion of students self-medicate about acne. The total knowledge score of self-medication was to some extent not relatively high. Educational programs can be developed to increase medical students' awareness of the risks and benefits of self-medication, information on appropriate use of medications, and when to seek medical attention., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

The present study aims to investigate the influence of zeolite usage and stocking densities on various parameters, including ammonia removal from water, accumulation of heavy metals in fish organs, water quality, growth performance, feed efficiency, muscle composition, as well as hematological and biochemical parameters in European seabass (Dicentrarchus labrax) over a 90-day duration. A total of 2400 D. labrax with an initial weight of 9.83 ± 2.02 g and initial length of 9.37 ± 0.32 cm were distributed among 24 tanks. The research involved six distinct treatment groups, with two different zeolite levels (0 and 15 ppt) and three stocking density levels (50, 100, and 150 fish/m3), each replicated four times. The results of the research demonstrate a statistically significant improvement (p < 0.05) in water quality measures with the introduction of zeolite. The successful implementation of this amendment mitigated the adverse effects of fish density on water quality parameters. Higher stocking density negatively impacted European sea bass growth, feed utilization, and hemato-biochemical indicators. Zeolite use effectively alleviated these adverse effects, particularly on performance, feed utilization, hematological, and biochemical parameters. The study's results indicate that the utilization of zeolite has shown to be efficacious in mitigating the accumulation of heavy metals in both water and fish organs, while concurrently augmenting fish attributes. However, the increase in density led to a significant decrease in the accumulation of heavy metals in both water and fish organs. The present study highlights the capacity of natural zeolites to mitigate the negative consequences associated with water quality concerns. The efficiency of these zeolites in limiting the accessibility of heavy metals in polluted water is shown, hence minimizing their accumulation in fish organs. In addition, the improvement of fish performance has the capacity to have a beneficial influence on both the well-being and efficiency of fish in aquaculture. Additional research is essential to fully understand the complex molecular pathways involved in utilizing natural zeolite under different fish densities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sallam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Pregnancy loss occurring before 20 weeks gestation is referred to as miscarriage. Various clinical presentations of miscarriage include threatened, inevitable, incomplete, complete, septic, and missed miscarriage. Early-stage threatened miscarriage may manifest with symptoms such as abdominal discomfort and vaginal bleeding. Threatened miscarriage is clinically defined as the manifestation of positive fetal heart sounds in pregnancies occurring before the 20th week of gestation, concomitant with vaginal bleeding and a closed cervix., Objectives: The primary aim of this study was to evaluate the association between serum C-reactive protein (CRP) levels and fetal ultrasound findings in the prediction of threatened miscarriage during the first trimester of pregnancy., Methods: In this prospective case-control study, a total of 100 pregnant women at 7-13 weeks of gestation were enrolled. All participants initially presented with a singleton embryo displaying cardiac activity on ultrasound. The study cohort was divided into two groups: Group 1 consisted of 50 women with uncomplicated pregnancies, while Group 2 comprised 50 women experiencing symptoms indicative of threatened miscarriage., Results: Notably, within Group 2, patients who eventually experienced miscarriage exhibited significantly elevated serum high-sensitivity CRP levels in comparison to those who maintained their pregnancies., Conclusions: Threatened miscarriage cases demonstrated a substantial increase in serum high-sensitivity CRP levels compared to the control group. Furthermore, CRP levels exhibited a correlation with the risk of miscarriage, suggesting their potential utility in conjunction with ultrasound parameters for prognosticating threatened miscarriage during the first trimester., Competing Interests: The authors assert they have no competing interests to disclose., (© 2024 Lotfy, Taha, Abdelmoaty, licensee HBKU Press.)

Objective: The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic., Methods: Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m 2 were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40-50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1 st 300 shocks. Success rate and complications were recorded., Results: Five hundred and ninety patients completed the study. The success rate after 1 st session was 408/590 patients (69.15%) which was augmented by 2 nd session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2)., Conclusions: SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Urology Annals.)

Although the rate of prosthetic joint infection (PJI) after total hip and knee arthroplasties (THA and TKA, respectively) is well documented in developed countries, there is a paucity of information in the literature on infection rates in low-and-middle-income countries. This study aims to review the PJI rate and management based on the Egyptian Community Arthroplasty Registry (ECAR) and six arthroplasty surgeons., Methods: Using data from the ECAR, for over 10 years, and surveying six high-volume arthroplasty surgeons, we reviewed the infection rate, common organisms, antibiotics used, and how the revision surgeries were done. The total number of patients included in this study was 210 infection cases out of 5216 THA and TKA., Results: Out of the 5216 joint replacement surgeries, the rate of all infections in THA and TKA was 4.03% (4.73 and 2.94%, respectively). The rate of infections requiring staged revision surgeries was 2.24 and 1.71% (2.03% in total) in the THA and TKA groups, respectively. The most encountered organism was Staphylococcus aureus . The common antibiotics used were vancomycin and a combination of cefoperazone and sulbactam., Conclusion: From this study, we conclude that THA was associated with a higher rate of PJI, surgeons' use of antibiotics for a relatively long period, and the rate of PJI in our setting is relatively higher than what is reported in developed countries but lower in other low-income settings. We believe that with improved operating theater design and infection control education, infection rates will decrease significantly. Finally, we acknowledge the need for a national arthroplasty registry that can help in documentation and improving patient outcomes., Competing Interests: The authors declare they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Escherichia coli ( E. coli ) is a Gram-negative bacterium that belongs to the family Enterobacteriaceae. While E. coli can stay as an innocuous resident in the digestive tract, it can cause a group of symptoms ranging from diarrhea to live threatening complications. Due to the increased rate of antibiotic resistance worldwide, the development of an effective vaccine against E. coli pathotypes is a major health priority. In this study, a reverse vaccinology approach along with immunoinformatics has been applied for the detection of potential antigens to develop an effective vaccine. Based on our screening of 5,155 proteins, we identified lipopolysaccharide assembly protein (LptD) and outer membrane protein assembly factor (BamA) as vaccine candidates for the current study. The conservancy of these proteins in the main E. coli pathotypes was assessed through BLASTp to make sure that the designed vaccine will be protective against major E. coli pathotypes. The multitope vaccine was constructed using cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), and B cell lymphocyte (BCL) epitopes with suitable linkers and adjuvant. Following that, it was analyzed computationally where it was found to be antigenic, soluble, stable, and non-allergen. Additionally, the adopted docking study, as well as all-atom molecular dynamics simulation, illustrated the promising predicted affinity and free binding energy of this constructed vaccine against the human Toll-like receptor-4 ( h TLR-4) dimeric state. In this regard, wet lab studies are required to prove the efficacy of the potential vaccine construct that demonstrated promising results through computational validation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Soltan, Behairy, Abdelkader, Albogami, Fayad, Eid, Darwish, Elhady, Lotfy and Alaa Eldeen.)

Background: Sepsis-induced diaphragmatic dysfunction is one of the main risk factors of failure to liberate patients from mechanical ventilation. Several studies addressed diaphragmatic ultrasound as a valuable tool in the assessment of diaphragmatic function during liberation from mechanical ventilation in different populations. However, none of these studies examined the use of diaphragmatic ultrasound to predict failure of liberation from mechanical ventilation in subjects with sepsis METHODS: A prospective observational study was done with subjects on mechanical ventilation and with abdominal sepsis. The diaphragmatic thickening fraction, diaphragmatic excursion, and rapid shallow breathing index were assessed 30 min after a spontaneous breathing trial RESULTS: Thirty subjects were enrolled in the study. Seventeen subjects were successfully extubated (56.6%), whereas extubation failed in 13 subjects (43.4%). The time to the first liberation attempt was significantly shorter in the liberation-success group 2.3 (0.7) d compared with the liberation-failure group 5.8 (4.7) d; P = .02. The optimum cutoff value of diaphragmatic thickening fraction for predicting liberation success was ≥30.7%, with a sensitivity of 94.1% and a specificity of 100%. The area under the curve was 0.977. Although diaphragmatic excursion of ≥10.4 mm had a sensitivity of 94% and a specificity of 85% for predicting liberation success, with an area under the curve of 0.85. A rapid shallow breathing index of ≤44 had a specificity of 100% and a sensitivity of 76%; the area under the curve was 0.9., Conclusions: Diaphragmatic ultrasound indices, namely diaphragmatic thickening fraction and diaphragmatic excursion, could be useful parameters for assessment of success of liberation in patients on mechanical ventilation with abdominal sepsis. (ClinicalTrials.gov registration NCT03094299.)., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2019 by Daedalus Enterprises.)

The neutrophil gelatinase-associated lipocalin (NGAL) has been emerging as a novel biomarker of acute kidney injury while its value in lupus nephritis is uncertain. The aim of this study was to assess urinary NGAL levels as a marker for disease activity in patients with lupus nephritis.This study included 70 systemic lupus erythematosus (SLE) patients; 50 with active lupus nephritis (LN) and 20 without as well as 20 matched controls. The neutrophil gelatinase-associated lipocalin (NGAL) in both serum and urine samples was measured by enzyme-linked immunosorbent assay (ELISA). Patients with active LN received standard treatment then assessed for response as well as the value of urinary NGAL (uNGAL). Our results revealed that, The SLE patients with or without LN had an elevated urinary NGAL as compared to controls (p < 0.000) and the mean of uNGAL was (20.67 ± 5.34),(10.63 ± 3.53),(5.65 ± 2.49) respectively. Furthermore,Urinary NGAL levels in LN patients were significantly higher than those in non-LN patients (P < 0.0001). In the ROC curve analysis , the diagnostic performance of uNGAL for discriminating patients with nephritis from those without nephritis showed that the best cutoff value was 13.66 ng/ml ,sensitivity 92%,specificity 75%,area undercurve (0.959) and (P < 0.0001). Measurement of urinary NGAL levels showed an excellent diagnostic performance for discriminating patients with LN from SLE without nephritis.