PubMed Health⌕ Search

Biomedical subjects

Harpal Lamba

Publications and source records attributed to Harpal Lamba.

5 recordsLinked to original sources

Recommendations for the management of premature ejaculation: BASHH Special Interest Group for Sexual Dysfunction.

We present the British Association for Sexual Health and HIV (BASHH), Special Interest Group for Sexual Dysfunction updated recommendations for the management of premature ejaculation. The recommendations outline the physiology, prevalence, definitions, aetiological factors and patient assessment for this common sexual problem. Behavioural, local and systemic pharmacological treatments are discussed along with general recommendations and auditable outcomes.

Adolescent↗

An atypical herpetic vulval ulcer in an African woman: an important lesson.

A 43-year-old woman from Southern Africa presented with an eight-month history of a painless vulval ulcer. She did not have any relevant past medical or drug history. She had never had, or ever been offered an HIV antibody test despite being from an endemic region. On examination, there was an ulcer on her right labia and a painless right inguinal lymph node. Herpes simplex virus (HSV) type 2 culture was positive. The HIV antibody test was also positive. Other cultures and serology including syphilis were negative. A biopsy was suggestive of herpes simplex. The vulval ulcer resolved on oral aciclovir only. Atypical genital herpes has been described in HIV disease, although it is often painful. This case emphasises the importance of offering an HIV antibody test to patients presenting with atypical genital ulcers. Moreover, it reinforces the paradigm that 'any anogenital ulcer (painful or not) can be herpetic in origin'.

Adult↗

Factors associated with sexual dysfunction in men with HIV infection.

Where men have had access to successful treatment for HIV (highly active antiretroviral therapy), expectations of both patients and physicians alike have changed significantly over the past decade. Such men, living with HIV, expect to lead fully functional lives including a normal sex life. Sexual dysfunction is well described among men with HIV. We retrospectively analysed details of 190 consecutive men attending a dedicated sexual dysfunction service in our HIV unit over an 18-month period. We took note of the specifics of their HIV disease, illnesses other than HIV, as well as other risk factors associated with sexual dysfunction. Men with sexual dysfunction all commonly reported recreational drug use, hepatitis B and C co-infection, anxiety and depressive illnesses, peripheral neuropathy and lipodystrophy. There was a significant relationship between men complaining of retarded ejaculation and peripheral neuropathy. Sexual dysfunction in non-HIV settings is known to lead to poor adherence to prescribed medications, e.g. antihypertensive agents. Iatrogenic sexual dysfunction in patients may similarly have a potential to lead to poor antiretroviral compliance if not addressed.

Adult↗

Antiretroviral therapy is associated with sexual dysfunction and with increased serum oestradiol levels in men.

Our objective was to determine the relationship between highly active antiretroviral therapy (HAART), serum total oestradiol and sexual dysfunction in HIV-infected men. Sexual difficulties were recorded prospectively in a cohort of HIV-negative (or unknown status) gay/bisexual men (MSM) and a cohort of HIV-infected men. The HIV-infected men were divided into those on and not on HAART and by sexuality. Serum total oestradiol and testosterone levels were evaluated where possible. One hundred HIV-negative MSM and 73 HIV-infected men (88% MSM) were analysed. Low libido and erectile dysfunction (ED) were reported in the control group in 2% and 10% respectively. This compared to a prevalence of 26% for both problems in HIV-infected MSM not taking HAART. In those MSM on HAART reduced libido was noted in 48% and ED in 25%. In the group of men taking HAART the mean oestradiol level was 228 pmol/L and was significantly above normal limits. Low libido and ED are more commonly reported in HIV-infected men compared to gay men of negative or unknown status. HAART is associated with a higher prevalence of lack of sexual desire and raised serum oestradiol levels.

Adult↗