Is There a Role for Levo-Thyroxine for the Treatment of Arterial Erectile Dysfunction? The Clinical Relevance of the Mean Platelet Volume

Background: Arterial erectile dysfunction (ED) is an early sign of vascular damage. Rare evidence has been published so far as to whether subclinical hypothyroidism (SCH) affects arterial erectile function. Therefore, the objective of this study was to fill this gap. Methods: Patients with arterial ED and SCH were consecutive enrolled and randomly divided into Group A (n = 20) and Group B (n = 20). Group A was treated with levo-thyroxine (LT4) at the dose of 1 µg/kg/day for six months, whereas patients of the group B did not receive any treatment. Thyroid stimulating hormone (TSH), free-thyroxine (FT4), peak systolic velocity (PSV), International Index of Erectile Function 5-item version (IIEF-5) score, mean platelet volume (MPV), and total cholesterol were evaluated at enrollment (T0) and after six months (T1). Patients without hypertension, diabetes mellitus, dyslipidemia, not on drugs, and with normal total testosterone (TT) values were included in this study. Results: Group A and B did not differ for age (61.2 ± 4.8 vs. 60.3 ± 5.6 years), body-mass index (28.7 ± 2.5 vs. 28.3 ± 2.6 Kg/m2), and serum TT levels (481.2 ± 54.0 vs. 492.1 ± 59.7 ng/dL). At T0, serum TSH levels (6.5 ± 1.2 vs. 6.0 ± 1.0 µIU/mL), FT4 (8.8 ± 0.6 vs. 8.8 ± 0.6 pmol/L), PSV (26.5 ± 1.4 vs. 25.8 ± 2.1 cm/s), IIEF-5 score (8.2 ± 1.7 vs. 9.0 ± 1.7), and total cholesterol (167.8 ± 21.7 vs. 171.6 ± 21.3 mg/dL) did not significantly differ in patients of Group A vs. those of Group B. MPV was significantly higher in Group A than in Group B (12.3 ± 0.3 vs. 11.8 ± 0.7 fL). At T1, Group A showed significantly lower TSH (2.26 ± 0.5 µIU/mL), MPV (9.5 ± 0.3 fL), and total cholesterol (137.8 ± 29.2 mg/dL) and significantly higher FT4 (9.3 ± 0.4 pmol/L), PSV (40.0 ± 2.6 cm/s), and IIEF-5 score (20.2 ± 3.6) compared to pre-treatment values. None of these endpoints showed significant change at T1 compared to T0 in patients of group B. Conclusions: Lt4 therapy is associated with an improvement of the erectile function at the vascular level, a decrease in MPV and total cholesterol. LT4 therapy should be considered in patients with arterial ED and SCH.

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Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.1.9 ◽

2014 ◽

Vol 86 (1) ◽

pp. 9 ◽

Cited By ~ 5

Author(s):

Domenico Prezioso ◽

Fabrizio Iacono ◽

Umberto Russo ◽

Giuseppe Romeo ◽

Antonio Ruffo ◽

...

Keyword(s):

Erectile Dysfunction ◽

Carotid Artery ◽

Doppler Ultrasound ◽

Erectile Function ◽

Color Doppler ◽

Peak Systolic Velocity ◽

Cavernosal Artery ◽

Vascular Origin ◽

Group A ◽

Group B

Objective: A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved, although cavernous peak systolic velocity (PSV) is generally considered a major parameter. Nevertheless the penile dynamic color Doppler is invasive and linked to several complications. The intima-media thicknesses (IMT) of cavernosal artery would add to the predictive value of vasculogenic ED risk and outcomes. We also hypothesized the existence of a correlation between IMT cavernosal artery and IMT carotid arteries. This study seeks to evaluate these hypotheses with our experience, investigating the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic ED. Material and methods: A total of 59 subjects (32 vasculogenic ED patients - group A - and 27 no vasculogenic ED patients - group B) were evaluated in our andrological center from September 2012 to June 2013 and enrolled in the study. All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution dynamic color Doppler ultrasound evaluation of carotid and penile districts and valutation of IMT in both districts. Results: The values of cavernosal artery IMT in group A were higher than in group B (0,28 ± 0,06 mm vs 0,17 ± 0,07 mm). Even the values of carotid artery IMT in vasculogenic ED group were higher than in no vasculogenic ED group (0,74 ± 0,14 mm vs 0,59 ± 0,11 mm). The cavernosal IMT showed a moderate (r = 0.61) positive linear correlation (p < 0.001) with the carotid artery IMT. Conclusions: An increased cavernous IMT might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase.

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Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

Polish Journal of Surgery ◽

10.1515/pjs-2015-0075 ◽

2015 ◽

Vol 87 (8) ◽

Cited By ~ 2

Author(s):

Santosh Kumar ◽

Rajesh Roat ◽

Swati Agrawal ◽

Kumar Jayant ◽

Ravimohan S. Mavuduru ◽

...

Keyword(s):

Erectile Dysfunction ◽

Combination Therapy ◽

Erectile Function ◽

T Test ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

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The Meaning of Serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio(PC/MPV) and plasma Fibrinogen in the Diagnosis of Periprosthetic Joint Infection

10.21203/rs.3.rs-138944/v1 ◽

2021 ◽

Author(s):

Jincheng Huang ◽

Jingyi Zhang ◽

Zongyan Gao ◽

Xiao Chen ◽

Zhipeng Dai ◽

...

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Joint Infection ◽

Volume Ratio ◽

Threshold Value ◽

Plasma Fibrinogen ◽

Platelet Volume ◽

Group A ◽

Group B ◽

Serum Crp

Abstract BackgroundThe purpose of this study was to test the meaning of serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV) and plasma Fibrinogen in periprosthetic joint infection diagnosis. MethodsClinical data of 160 patients diagnosed with osteoarthritis (Group A), PJI (Group B) and aseptic loosening after joint arthroplasy (Group C) were retrospective studied. General data and preoperative serum CRP, ESR, Platelet count to Mean Platelet Volume ratio and plasma Fibrinogen level were recorded and compared.ResultsSerum CRP, ESR, PC/MPV and plasma Fibrinogen expression level in Group B are much higher than Group A and C. When PC/MPV>31.70 was set as the optimum threshold value for the diagnosis of PJI, the specificity of PC/MPV in PJI diagnosis was lower than CRP and ESR, whereas, the sensitivity of PC/MPV in PJI diagnosis was similar with CRP and ESR. When plasma Fibrinogen > 4.01 μg/mL was set as the optimum threshold value for the diagnosis of PJI, the specificity and sensitivity of plasma Fibrinogen in diagnosis of PJI was similar with CRP and ESR. ConclusionPC/MPV should not be used as the first screen marker for PJI diagnosis, whereas, the plasma Fibrinogen can be used as a new marker for PJI diagnosis.

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Can Eosinophil Count, Platelet Count, and Mean Platelet Volume Be a Positive Predictive Factor in Penile Arteriogenic Erectile Dysfunction Etiopathogenesis?

American Journal of Men s Health ◽

10.1177/1557988316679575 ◽

2016 ◽

Vol 11 (3) ◽

pp. 678-683 ◽

Cited By ~ 4

Author(s):

Mehmet Giray Sönmez ◽

Yunus Emre Göğer ◽

Leyla Öztürk Sönmez ◽

Arif Aydın ◽

Mehmet Balasar ◽

...

Keyword(s):

Platelet Count ◽

Erectile Dysfunction ◽

Predictive Factor ◽

Blood Cells ◽

Mean Platelet Volume ◽

Eosinophil Count ◽

Erectile Function ◽

Doppler Ultrasonography ◽

Platelet Volume ◽

Significant Difference

Blood count parameters of patients referring with erectile dysfunction (ED) were examined in this study and it was investigated whether eosinophil count (EC), platelet count (PC), and mean platelet volume values among the suspected predictive parameters which may play a role in especially penile arteriogenic ED etiopathogenesis had a contribution on pathogenesis. Patients referring with ED complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function. Penile Doppler ultrasonography was taken in patients suspected to have vasculogenic ED. According to penile Doppler ultrasonography result, patients with arterial deficiency were included in the penile arteriogenic ED group and the patients with normal results were included in the nonvasculogenic ED group. A total of 36 patients participated in the study from the penile arteriogenic ED group and 32 patients from the nonvasculogenic ED group. Compared with the nonvasculogenic ED group, the penile arteriogenic ED group’s low International Index of Erectile Function score, high EC, mean platelet volume and PC values were detected to be statistically significant ( p < .001, p = .021, p = .018, p = .034, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells, and hemoglobin values were considered. Pansystolic volume velocities were detected as statistically significantly low compared with the nonvasculogenic ED group in the measurements made in 5th, 10th, 15th, and 20th minutes on the right and left sides in the penile arteriogenic ED group. High MPV value and PC is a significant predictive factor for penile arteriogenic ED and vasculogenic ED and high EC is specifically predictive of arteriogenic ED.

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Plasma Fibrinogen is a good new auxiliary diagnostic marker for periprosthetic joint infection

10.21203/rs.3.rs-60914/v1 ◽

2020 ◽

Author(s):

Jincheng Huang ◽

Xiao Chen ◽

Shuo Qiang ◽

Wendi Zheng ◽

Jia Zheng ◽

...

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Joint Infection ◽

Volume Ratio ◽

Plasma Fibrinogen ◽

Platelet Volume ◽

Group A ◽

Group B ◽

Serum Crp ◽

D Dimer

Abstract Background: To test the meaning of serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer in periprosthetic joint infection diagnosis (PJI). Methods: Clinical data of 149 patients diagnosed with osteoarthritis (Group A), PJI (Group B) and aseptic loosening after joint arthroplasy (Group C) were retrospectively studied. General data and preoperative serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer levels were analyzed. The sensitivity and specificity of serum CRP, ESR, Platelet Count and Mean Platelet Volume ratio (PC/MPV), plasma Fibrinogen and D-Dimer in PJI diagnosis were compared.Results: Expression level of serum CRP, ESR, PC/MPV and plasma Fibrinogen in Group B are higher than Group A and C. Expression level of plasma D-Dimer in Group B are higher than Group A but similar with Group C. When PC/MPV>31.70, plasma Fibrinogen > 4.01 μg/mL and plasma D-Dimer > 1.17 mg/L were set as the threshold value for the diagnosis of PJI, the sensitivity of PC/MPV in PJI diagnosis is lower than ESR and Plasma Fibrinogen. Whereas, there are no statistically significant differences when compared specificity of serum CRP, ESR, PC/MPV, plasma Fibrinogen and D-Dimer in PJI diagnosis.Conclusion: PC/MPV and plasma D-Dimer should not be used as the first screen markers for PJI diagnosis, whereas, the plasma Fibrinogen can be used as a new auxiliary marker for PJI diagnosis.

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Mean platelet volume indicator for systemic inflammation in cirrhotic patients with spontaneous bacterial peritonitis

QJM ◽

10.1093/qjmed/hcab100.003 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Khaled Mohamed Abd El-Wahab ◽

Moataz Mohamed Sayed ◽

Mohamed Osama Ali ◽

Abd El-Azem Mostafa Abd El-Azem

Keyword(s):

Mean Platelet Volume ◽

Spontaneous Bacterial Peritonitis ◽

Platelet Volume ◽

Bacterial Peritonitis ◽

Function Test ◽

Group A ◽

Cirrhotic Patients ◽

The Mean ◽

Group B ◽

Ascetic Fluid

Abstract Introduction spontaneous bacterial peritonitis (SBP) is the most common infection in patients with cirrhosis [1] .Spontaneous bacterial peritonitis is found in patients where besides the increase of polymorphonuclear counting, they present a positive result of culture [2] . The BMN count as not always quickly available in clinical practice and the culture result usually takes 72 hours or more [3] .The use of additional markers that are rapidly and easily applicable, may add significant benefit for predicting the development of spontaneous bacterial peritonitis and achieving diagnostic accuracy [4] .Platelet size is a determinant factor of platelet proinflammatory functions. Several studies have found relationship between the mean platelet volume (MPV) and pro-inflammatory conditions, particularly acute infections [5] . Aim to identify a mean platelet volume (MPV) cutoff value which should be able to predict the presence of sponataneous bacterial peritonitis. Settings and designs a cross sectional observational study, carried out on 40 patients with AFI and 40 patients without AFI. Methods Patients were classified into two groups, group A (SBP) which included 40 patients with ascetic fluid PMN count ≤ 250 cells/mm3 and group B (non/SBP) which included another 40 patients with ascetic fluid PMN count < 250 cells/mm3. All studied patients were subjected to history taking, Clinical examination and routine laboratory investigations including: CBC including platelet number and MPV, liver function test including (ALT, AST, albumin, and direct & total bilirubin), kidney function test including (BUN &creatinine), PT, PTT, INR, ESR and CRP .Abdominal-pelvic ultrasonography was done for all patients. Aspirated ascetic fluid samples were immediately examined for bacteriological cultures. Statistical analysis used Statistical presentation and analysis of the present study was conducted, using the mean, standard deviation, independent samples t-test, Chi-square, Mann-Whitney U test and Analysis of variance [ANOVA] tests by SPSS version 22 software .Tukey test was used .Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of MPV and with maximum sensitivity and specificity for differentiation of cirrhotic patients with SBP from those without SBP. Spearman’s correlation analysis was done. Results MPV was significantly higher in SBP-patients (Group A) than that of non-SBP patients (Group B) (11.6820±1.19303 fL versus 9.0325±1.12441 fL) (P-value = 0.001) .MPV has positive correlation with Ascitic sample TLC and Ascitic sample PMNC in Group A. ROC curve shows that MPV cut off value is10.25with 85% sensitivity and 75% specificity . Conclusion MPV may serve as a non-invasive, cheap and rapid test for detection and diagnosis of spontaneous bacterial peritonitis (SBP) with a sensitivity and specificity of 85% and 75% respectively.

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Plasma Fibrinogen Can be Used as a New Auxiliary Diagnostic Marker for Periprosthetic Joint Infection

10.21203/rs.3.rs-60961/v1 ◽

2020 ◽

Author(s):

Jincheng Huang ◽

Xiao Chen ◽

Shuo Qiang ◽

Wendi Zheng ◽

Jia Zheng ◽

...

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Joint Infection ◽

Volume Ratio ◽

Plasma Fibrinogen ◽

Platelet Volume ◽

Group A ◽

Group B ◽

Serum Crp ◽

D Dimer

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Is it safe to incise skin by monopolar electrocautery? A comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20192147 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1931

Author(s):

Nimesh B. Thakkar ◽

Pranav Patel ◽

Gautam Sonagra

Keyword(s):

Skin Incision ◽

Healing Time ◽

Skin Wound ◽

Cosmetic Result ◽

Advantages And Disadvantages ◽

Study Results ◽

Group A ◽

Selection For ◽

Group B ◽

Monopolar Electrocautery

Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.

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Effect of lactation on serum total cholesterol & triglyceride

Bangladesh Journal of Physiology and Pharmacology ◽

10.3329/bjpp.v29i1-2.20060 ◽

2014 ◽

Vol 29 (1-2) ◽

pp. 1-7

Author(s):

Khadiza Begum ◽

Rokeya Begum ◽

Qazi Shamima Akhter ◽

Nusrat Sultana ◽

Shamima Bari

Keyword(s):

Total Cholesterol ◽

Study Groups ◽

Cross Sectional Study ◽

Serum Total Cholesterol ◽

Cross Sectional ◽

Medical College ◽

Data Collection Sheet ◽

Group A ◽

Group B ◽

High Level

Background: There is an association between breast feeding & maternal lipid profile. Pregnancy related hyperlipidaemia reverse quickly with lactation. Objective: To observe Serum Total cholesterol & triglyceride in lactating & nonlactating mother. Method: The present cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of July 2010 to June 2011. A total 300 subjects were included within the age limit from 20 to 40 years of women. Among them100 were normal healthy subjects & had child above 3 years were considered as group A (control). The rest 200 women were selected as study subject (group B) having child between the age 6 weeks to 2 years. Group B is again subdivided into group B1 (100 lactating mother) & group B2 (100 nonlactating mother). The subjects were selected from pediatric ward & OPD of pediatrics, DMCH and BSMMU, Dhaka. Data were collected in data collection sheet after taking informed written consent of the subjects. The study parameters total cholesterol & Triglyceride were done in the Department of Physiology, Dhaka Medical College. The data were analyzed by computer with SPSS programs using unpaired Student ?t test.Results: In group B1 total cholesterol & triglyceride levels were non significantly higher than that of group A but in group B2 these values were significantly higher than that of group A. Within the study groups all these values were significantly higher in nonlactating mother than lactating mother. It was observed that high level of study parameters were more in B2 than that of group B1. Conclusion: From the results of the present study it may be concluded that lactation has effect on lowering serum total cholesterol & triglyceride which may preferably related to health education for the mother. http://dx.doi.org/10.3329/bjpp.v29i1-2.20060Bangladesh J Physiol Pharmacol 2013; 29(1&2) : 1-7

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WOUND DEHISCENCE;

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.08.59 ◽

2018 ◽

Vol 25 (08) ◽

pp. 1143-1146

Author(s):

Ammrah Tahir ◽

Muhammad Sajid Hameed Ansari ◽

Abdul Waheed Khan

Keyword(s):

Controlled Trial ◽

Wound Dehiscence ◽

Midline Laparotomy ◽

Mass Closure ◽

Generalized Peritonitis ◽

Study Results ◽

Group A ◽

Continuous Mass ◽

Group B ◽

Laparotomy Incision

Objectives: To compare the continuous and interrupted closure in term offrequency of wound dehiscence in emergency midline laparotomy incision. Study Design:Randomized controlled trial. Setting: Surgical Unit-I, Allied Hospital Faisalabad. Period: From15th March 2014 to 15th November 2014. Material and Methods: Two hundred patients werediagnosed clinically by taking thorough history and examinations were included. Fascial layerof wound of the patients sampled for group A was closed with interrupted mass closure withprolene no.1 whereas in group B was closed by continuous mass closure with prolene no1. All included patients were kept nothing by mouth. Resuscitation was done with, ringerslactate and blood transfusion if needed until adequate urine output (0.5 ml/kg/hr). Base lineinvestigations were done. After resuscitation and giving preoperative antibiotics, patients wereexplored through mid-line incision. Obvious source of contamination was dealt with accordingly.Variables wound were examined daily for any sign of dehiscence. Temperature pulse wasmeasured daily along with surgical site examination for any kind of discharge, stitches cutthrough and gut visibility through wound. In case of no complication patient was discharged ontenth postoperative day, which was the end point of study. Results: There were 61 (61%) malesand 39 (39%) females in group A, while in group B, 63 (63%) males and 37 (37%) females withmean ages of patients were 39.77+10.16 and 38.61+9.75 respectively. The wound dehiscencewere found 7 (7%) in Group-A and 18(18%) in Group-B while remaining 93 (93%) in Group-Aand 82 (82%) in Group-B had no morbidity statistically (p<0.01). Conclusion: It is concludedthat wound dehiscence is significantly higher in continuous closure as compare to interruptedclosure for emergency midline laparotomy incision for generalized peritonitis.

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