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Biomedical subjects

Howayda M Hassoba

Publications and source records attributed to Howayda M Hassoba.

4 recordsLinked to original sources

Age related testosterone depletion in patients with erectile dysfunction.

PURPOSE: We assessed the pattern of age related testosterone depletion in patients with erectile dysfunction. MATERIALS AND METHODS: A total of 305 patients with erectile dysfunction who had a normal testosterone level at baseline visit and who completed the study were candidates for analysis. Erectile function was assessed using the International Index of Erectile Function. Patients underwent routine laboratory investigations plus total testosterone and prolactin assessment at the baseline visit and on a yearly basis for 4 years. RESULTS: The mean age +/- SD was significantly higher in 210 patients with decreased testosterone (55.3 +/- 7.3 years) than in 95 patients with steady testosterone (remaining within the normal range) (50.8 +/- 10.2 years). There was a significant decrease in yearly mean testosterone level throughout the study in all the age groups (determined by decades) older than 30 years. Of the study population 68.9% had decreases in testosterone levels throughout the 4 years of visits. Hypogonadism (testosterone lower than normal range) developed in 7.6% of the study population. There was a significant decrease in mean testosterone at any visit in comparison to previous visits. There were significant associations between decreased levels of testosterone and increased severity of erectile dysfunction at baseline visit, longer duration and poor metabolic control of diabetes, ischemic heart disease, hyperprolactinemia and low desire. CONCLUSIONS: This study clearly demonstrated a decrease in testosterone level throughout the 4-year followup in patients with erectile dysfunction. Patients with decreasing testosterone were older than patients with a steady testosterone level.

Adult↗

Pattern of endocrinal changes in patients with sexual dysfunction.

INTRODUCTION: Many patients with endocrinal changes (endocrinopathy) have some degrees of sexual dysfunction that necessitate assessment and treatment. AIM: To assess the prevalence, and identify the pattern, of endocrinopathy in patients with sexual dysfunction in our community. METHODS: A total of 1,248 male patients with sexual dysfunction were enrolled in this study. Patients were screened for erectile dysfunction (ED) and sexual desire by the erectile function and the sexual desire domains of the International Index of Erectile Function (IEEF). Patients underwent routine laboratory investigations as well as total testosterone and prolactin assessment. All patients were referred to an endocrinologist for clinical and biochemical assessment of their endocrine function. The evaluation consisted of comprehensive history taking, physical examination, and, as needed, laboratory investigations. RESULTS: Mean ages+/-SD were 51.9+/-12.2 and 52.3+/-11.7 years for patients with and without endocrinopathy, respectively. Of the study population, 23.8% had endocrinopathy. The most frequent endocrinal changes were low testosterone level (15%), hyperprolactinemia (13.7%), and hypothyroidism (3.1%). There were significant associations between endocrinopathy and obesity, smoking, low desire, and premature ejaculation (P<0.05 for each). Also, significant associations were found between low desire and low testosterone level, hyperprolactinemia, and hypothyroidism (P<0.05 for each). Hyperprolactinemia was significantly associated with premature ejaculation (P<0.05) but not with low testosterone level (P>0.05). There was no significant association between endocrinopathy and age, cigarette smoking (number and duration), and ED (duration, severity, type of onset, and progression) (P>0.05 for each). CONCLUSION: Endocrinopathy is not a rare condition among ambulatory patients with sexual dysfunction. This study provides a quantitative estimate of endocrinopathy in ambulatory patients with sexual dysfunction.

Comorbidity↗

Prostatic specific antigen in patients with hypogonadism: effect of testosterone replacement.

INTRODUCTION: The effect of parenteral testosterone replacement therapy on prostatic specific antigen (PSA) level or the development or growth of prostate cancer is unclear. AIM: To assess the effect of testosterone replacement on PSA level in patients with hypogonadism associated with erectile dysfunction (ED). METHODS: A total of 187 male patients above the age of 45 with hypogonadism associated with ED were enrolled in this study. Patients were screened for ED by the erectile function domain of the International Index of Erectile Function (IIEF). Patients underwent routine laboratory investigations, plus total testosterone, and PSA assessment. Replacement treatment with parenteral testosterone every 2-4 weeks for 1 year was instituted. Total testosterone and PSA serum levels were assessed every 3 months during the treatment course. RESULTS: Mean age +/- SD was 62.8 +/- 11.4. Of the patients 87.7% were sexually active. Of the patients 10.2% had mild, 40.6% had moderate and 49.2% had severe ED. Of the study population, 62.5% had ED complaints for less than 5 years and 84.5% had gradual onset of their complaint. The majority of the patients (91.4%) had either progressive or stationary course while the minority reported regressive course and improvement of the condition. There was a significant increase of the post-treatment testosterone level in comparison to pretreatment level (P < 0.05). No significant increase in the post-treatment PSA level in comparison to pretreatment (P > 0.05). No significant difference between pre- and post-treatment categories of PSA level (normal, borderline, high) in relation to the severity of ED (P > 0.05). There was no significant association between PSA level and the duration of testosterone replacement therapy in the study population (P > 0.05). CONCLUSION: The current study demonstrated that the level of PSA was not significantly changed after 1 year of testosterone replacement therapy in patients with hypogonadism associated with ED.

Aged↗

Soluble ICAM-1 in patients with chronic hepatitis C infection: a prognostic marker of disease activity.

Soluble intercellular adhesion molecule-I (sICAM-1) is an important early marker of response to inflammatory mediators and immune activation released from a variety of cells including hepatocytes. At present, the most reliable determination of severity and prognosis in chronic viral hepatitis is the histological staging of the disease which is an invasive procedure and is often not well accepted by patients. The search for alternative non-invasive methods is mandatory especially in follow ups after initial assessment by biopsy. Serum sICAM-1 level was measured in 19 patients with chronic HCV, 19 patients with non-B, non-C chronic liver diseases (NBNC-CLD) and in 19 healthy control subjects using ELISA. Serum sICAM-1 levels were significantly higher in patients with chronic HCV and in NBNC-CLD patients compared to normal subjects (mean +/- SD, [1003 +/- 453 vs. 232 +/- 177, p<0.001], and [881 +/- 328 vs. 232 +/- 177, p<0.001]), respectively. Furthermore, serum levels of sICAM-1 were significantly higher in HCV-RNA positive patients than in HCV-RNA negative patients (p<0.001). Positive correlations were detected between serum levels of sICAM-1 and serum alanine aminotranseferase (ALT) (p<0.001), aspartate aminotranseferase (AST) (p<0.001), prothrompin time (p<0.001), and alkaline phosphatase (p<0.001), while, a negative correlation with albumin was found (p<0.001). Also, there was a significant correlation between clinical, ultrasonic findings and the level of sICAM-1 in chronic HCV patients as regards hepatomegaly, splenomegaly and normal liver echogenecity. High knodell score was significantly associated with high sICAM-1 level (p<0.001) in both patient groups. while no association between sICAM-1 and fibrosis was found. In conclusion, the measurement of sICAM-1 serum levels in chronic hepatitis C and NBNC-CLD patients is a useful non-invasive marker for monitoring liver disease activity that could replace follow up liver biopsies that are mostly not welcomed by the patients.

Adult↗