This review is designed to help the reproductive endocrinologist integrate his or her professional activity with those of other disciplines including urology, radiology, neurology, and psychology in order to successfully manage all of the inseparable aspects of male sexual and reproductive functioning. Significant advances in the field of male sexual physiology and pathophysiology and new methods of investigation and treatment of male sexual disorders are outlined. The review synthesizes available data on the following: norms of sexual organs, aging and sexuality, role of central and peripheral neurochemicals in each stage of the sexual cycle, role of corporeal smooth muscles in the hemodynamic control of erection and detumescence, influence of psychological factors, drugs, and disease on all aspects of sexual functioning, and use of nocturnal penile tumescence monitoring, imaging investigations, and neurophysiologic studies in the diagnostic workup of males with sexual dysfunction. Clinical algorithms are presented where appropriate. Extensive discussions on newly developed strategies in psychological and behavioral counseling, drug therapy, tissue engineering, nonsurgical devices, and surgical treatments for all forms of sexual disorders are also provided. Lastly, the effect of sexual dysfunction and its treatment on quality of life in affected men is addressed, along with recommendations for future research endeavors.

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Male Sexual Function and Its Disorders: Physiology, Pathophysiology, Clinical Investigation, and Treatment

Erectile dysfunction

The risk of recurrence of inguinal hernia within 5 years of repair is lower after mesh than sutured repair in men, but no large‐scale studies have compared the risk of recurrence beyond 5 years.

Risk of recurrence 5 years or more after primary lichtenstein mesh and sutured inguinal hernia repair (Br jsurg 2007; 94: 1038-1040). Authors' reply

The current study aimed to investigate the influence of dietary zinc nanoparticles (ZnNPs), curcumin nanoparticles (CurNPs), and Bacillus licheniformis (Bl) on the growth, carcass, blood metabolites, and the count of some cecal microorganisms of Indian River (IR) broilers. Chicks were allotted into seven experimental groups: control group, 1st, 2nd and 3rd groups were given diets enriched with ZnNPs, CurNPs and Bl (3.0, 5.0 and 2.0 cm3/kg diet, respectively). The 4th, 5th and 6th groups were given diets supplemented with ZnNPs (3.0) + Bl (2.0) (ZP); ZnNPs (3.0) + CurNPs (5.0) (ZC) and ZnNPs (3.0) + CurNPs (5.0) + Bl (2.0) (ZCP) cm3/kg diet, respectively. The results revealed that ZnNPs and CurNPs exhibited a considerable antimicrobial activity against pathogenic bacteria and fungi. They also inhibited the growth of microbes in a range of 50-95 µg/mL. The diet supplemented with ZnNPs, CurNPs, and Bl increased the body weight compared to the control after five weeks of age. Additionally, values of daily feed intake increased in these groups; however, the feed conversion ratio decreased. All values of carcass traits were better than that of the control. The treatments led to decreased abdominal lipids compared to the control. The activity of liver enzymes and malondialdehyde (MDA) activity decreased in the treated groups. In a converse trend, the levels of oxidative enzymes, amylase, protease, lipase and immunoglobulin were higher than that of the control. Meat quality properties were improved and cecal microbial counts were decreased. In conclusion, the ZnNPs, CurNPs, and Bl improved the broiler's weights, carcass traits, meat quality traits, as well as some blood indices and cecal microbial load. Therefore, the inclusion of ZnNPs, CurNPs, or Bl is recommended for broiler feeding regimens to improve the performance and health status.

Impacts of Supplementing Broiler Diets with Biological Curcumin, Zinc Nanoparticles and Bacillus licheniformis on Growth, Carcass Traits, Blood Indices, Meat Quality and Cecal Microbial Load

A total of 200 1-week-old Japanese quails were randomly allocated into five treatment groups, each consisting of 40 unsexed birds (five replicates, eight birds each). Quails were reared in traditio...

Use of biological nano zinc as a feed additive in quail nutrition: biosynthesis, antimicrobial activity and its effect on growth, feed utilisation, blood metabolites and intestinal microbiota

Objective: To examine the effectiveness in treating impotence of topically applied cream containing three vasodilators—aminophylline, isosorbide dinitrate, and co-dergocrine mesylate—which act by different mechanisms. Design: Randomised double blinded placebo controlled crossover trial over two weeks. Subjects: 36 men with erectile dysfunction randomly allocated to two equal groups. Interventions: Active cream containing aminophylline 3%, isosorbide dinitrate 0.25%, and co-dergocrine mesylate 0.05% for one week and placebo for another. Main outcome measures: Patients9 reported experience of penile responses and side effects of treatment in questionnaires. Penile tumescence and arterial flow in the laboratory. Results: 21 patients reported full erection and satisfactory intercourse with the active cream. Three men reported full erection and satisfactory intercourse with either cream. The active cream was more effective in psychogenic than organic impotence (eight out of nine men with psychogenic impotence achieved a full erection v four out of eight with neurogenic impotence and two out of seven with arterial insufficiency). No major side effects were reported. In the laboratory the active cream increased penile arterial flow (0.19 (SD 0.08) m/s v 0.02 (0.15) m/s with placebo) and induced tumescence in 24 patients. Conclusions: Topical treatment with a cream containing three different vasodilators might be considered before intracavernous injection of vasoactive agents, particularly in psychogenic impotence. Key messages In this study a topical cream containing three vasodilators with different mechanisms of action was tested in a double blind placebo controlled crossover trial in 36 impotent men The active cream increased penile arterial flow and induced tumescence in the laboratory, and 21 patients reported full erection and intercourse after a week9s treatment The cream was most effective in psychogenic impotence, success rates being lower when the impotence had organic causes This topical treatment should be used before intracavernous agents, especially in psychogenic impotence

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Topical treatment of erectile dysfunction : randomised double blind placebo controlled trial of cream containing aminophylline, isosorbide dinitrate, and co-dergocrine mesylate

The current study investigated the effects of zinc oxide nanoparticles (ZONPs) and oxytetracycline (OTC) supplementation on broilers’ behavior, performance, carcass quality, biochemical parameters, and intestinal microbial populations and birds’ response to Newcastle disease (ND) vaccine. A total of 336 seven-day-old IR broiler chicks were randomly allotted to six dietary treatments containing 0, 10, 20, 30 and 40 ppm ZONPs or 50 ppm OTC. Each diet was fed to 7 replicates (8 birds/pen). The results clarified that 10 ppm ZONPs significantly improved the body weight gain and feed conversion in comparison to the control. No changes in behavior were recorded. The 10 ppm and 30 ppm ZONPs and OTC significantly reduced the gizzard weight in comparison to the control. While, 10 ppm ZONPs significantly increased the spleen weight, and all ZONPs doses increased bursa weight in comparison to the control and OTC groups. 20 ppm ZONPs increased the eviscerated yield and edible yield in comparison to the control and OTC groups. 40 ppm ZONPs increased pH, reduced meat color and overall acceptability in comparison to the control. In addition, results revealed that the 20 ppm ZONPs increased Calcium (Ca), High density low cholesterol (HDL-C), reduced urea (UA) and triglyceride (TG). Also, 40 ppm ZONPs and OTC increased creatinine (Cr) and reduced ND-HI titer in comparison to the control. For microbial population, OTC group was significantly lower than ZONPs groups in the total anaerobic, aerobic and lactobacilli count. In conclusion, the dietary inclusion of ZONPs can be applied as antibiotic growth promoter substitutions in broilers’ diet. However, further investigations are still needed.

Effect of zinc oxide nanoparticles on broilers’ performance and health status

The current experiment was designed to evaluate the effects of dietary supplementations of zinc oxide nanoparticles (ZONPs) on some behavioural, performance, welfare and histopathological changes i...

Zinc oxide nanoparticles prevent multidrug resistant Staphylococcus-induced footpad dermatitis in broilers

Repair of fistulae in-ano in children using image guided Histoacryl injection after failure of conservative treatment.

Aim To evaluate the feasibility and safety of laparoscopic ligation of internal ring in congenital inguinal hernia in children. Patients and methods Laparoscopic percutaneous ligation of internal inguinal ring has been performed on 97 children with 133 hernias. The age ranged between 6 months and 11.5 years. The procedure was carried out under general anesthesia, through skin puncture opposite to the lateral edge of the internal ring. The needle was passed under direct vision to encircle the internal ring without touching the vas or testicular vessels. The heel of the needle is backed through the subcutaneous tissue and out of the original stab puncture. The contralateral side was examined and the internal ring was closed if it was patent. Results All children were subjected to a follow-up schedule for 1 year to evaluate both efficacy and reliability of the technique. The mean operative time in our series was 15 (± 3) and 20 (± 5) min for bilateral cases, without anesthesia time. Of 133 hernias repaired, two hernias recurred at 1 and 2 months postoperatively. Conversion rate was 0% in our hands. Five (3.8%) cases developed minimal extraperitoneal hemorrhage during surgery. Six (4.5%) cases developed mild hydrocele, which was successfully treated conservatively. Conclusion Laparoscopic percutaneous ligation of internal inguinal ring repair of congenital hernia is proved to be a safe, simple, and easy procedure and can be performed routinely. The procedure has better cosmetic effect because we use a single umbilical port only. The high safety of the procedure we devised is because the cord contents remained untouched during the procedure. Keywords: extracorporeal, inguinal hernia, laparoscopy, subcutaneous ligation

Mohamed A. Osman

Papers

Topical treatment of erectile dysfunction : randomised double blind placebo controlled trial of cream containing aminophylline, isosorbide dinitrate, and co-dergocrine mesylate

Effect of zinc oxide nanoparticles on broilers’ performance and health status

Zinc oxide nanoparticles prevent multidrug resistant Staphylococcus-induced footpad dermatitis in broilers

Repair of fistulae in-ano in children using image guided Histoacryl injection after failure of conservative treatment.

Laparoscopic-assisted percutaneous internal ring ligation in children