Genital size is a crucial index for the assessment of male sexual development, as abnormal penile or testicular size may be the earliest visible clinical manifestation of some diseases. However, there is a lack of data regarding penile and testicular size measurements for Chinese boys at all stages of childhood and puberty. This cross-sectional study aimed to develop appropriate growth curves and charts for male external genitalia among children and adolescents aged 0-17 years in Chongqing, China. A total of 2974 boys were enrolled in the present study. Penile length was measured using a rigid ruler, penile diameter was measured using a pachymeter, and testicular volume was determined using a Prader orchidometer. Age-specific percentile curves for penile length, penile diameter, and testicular volume were drawn using the generalized additive models for location, scale, and shape. Very similar growth curves were found for both penile length and penile diameter. Both of them gradually rose to 10 years of age and then sharply increased from 11 to 15 years of age. However, testicular volume changed little before the age of 10 years. This study contributes to the literature covering age-specific growth curve and charts about male external genitalia in Chinese children and adolescents. These age-related values are valuable in evaluating the growth and development status of male external genitalia and could be helpful in diagnosing genital disorders.

Male external genitalia growth curves and charts for children and adolescents aged 0 to 17 years in Chongqing, China

Introduction Phosphodiesterase type 5 (PDE5) hydrolyses cyclic guanylate monophosphate specifically to 5′ guanylate monophosphate, promoting corporeal vascular relaxation and penile erection in response to sexual stimulation. Oral PDE5 inhibitors (PDE5-Is) have afforded effective and well-tolerated treatment for erectile dysfunction. In addition, PDE5-Is have stimulated academic and clinical interest for their potential benefits in diverse non-sexual applications. Aim To highlight possible potential non-sexual implications of PDE5-Is. Methods A systematic review was conducted until January 2016 based on a search of all relevant articles in Medline Medical Subject Heading, Scopus, Cochrane Library, EMBASE, and CINAHL databases without language restriction. Key words used to assess outcome and estimates for the relevant associations were PDE5 inhibitors, sildenafil, tadalafil , vardenafil , and avanafil. Main Outcome Measures Different non-sexual implications for PDE5-Is. Results PDE5-Is demonstrated beneficial effects in different medical applications with possible widespread implications for cardiovascular, pulmonary, cutaneous, gastrointestinal, urogenital, cellular, musculoskeletal, neurologic, and reproductive disorders. However, most applications were carried out experimentally in preclinical studies of off-label indications. Conclusion PDE5-Is are a conceptually attractive therapeutic class of agents with pleiotropic effects. Exploring PDE5-Is for their possible implications seems to be valuable in different medical disorders. However, well-designed clinical trials are needed before these agents can be recommended for selected applications. Mostafa T. Non-Sexual Implications of Phosphodiesterase Type 5 Inhibitors. Sex Med Rev 2017;5:170–199.

Non-Sexual Implications of Phosphodiesterase Type 5 Inhibitors

Self-management education among women with pre-existing diabetes in pregnancy: A scoping review

Objectives To construct chorionicity-specific birth-weight reference charts for dichorionic diamniotic (DCDA) and monochorionic diamniotic (MCDA) twin pregnancies, incorporating estimated-fetal-weight (EFW) data in order to adjust for the relationship between suboptimal growth and preterm delivery. An additional aim was to determine if the inclusion of complicated twin pregnancies impacts on the reference charts produced. Methods The inclusion criteria for this retrospective cohort study were twin pregnancy of known DCDA or MCDA chorionicity, known pregnancy outcome, last ultrasound scan within 14 days before birth and delivery between 25 and 38 weeks' gestation (Analysis A). An analysis was also conducted excluding pregnancies with complications recorded (Analysis B). Previously published twin EFW reference ranges were used in the analysis. A joint statistical model for EFW and observed birth weight for each pregnancy was created in order to estimate population birth-weight reference ranges corresponding to the distribution expected if all pregnancies delivered at any given gestational age. It was not assumed that the median EFW was equal to birth weight for any given gestational age. The models were fitted using a Bayesian approach. Results We retrieved data on 1664 twin pregnancies, of which 707 DCDA and 241 MCDA pregnancies met the inclusion criteria. In Analysis A, the estimated population median birth weight was similar to the median EFW at around 27 weeks' gestation but fell below the EFW values with increasing gestation, being 156 g lower in both DCDA and MCDA pregnancies at 35 weeks; this finding was confirmed by direct comparison of the last EFW and birth-weight values in each pregnancy. When the analysis was repeated after excluding complicated twin pregnancies (Analysis B), compared with Analysis A, there was very little difference in the median birth-weight results obtained across gestation. The largest absolute difference between Analyses A and B for DCDA twins was at 31, 32 and 33 weeks, with a 9-g lower median birth weight in Analysis A compared with Analysis B. The largest absolute difference for MCDA twins was greater than that for DCDA twins, with a 21-g lower median birth weight at 25 weeks in Analysis A compared with Analysis B. Conclusions We have established population chorionicity-specific birth-weight reference charts for DCDA and MCDA twin pregnancies, corresponding to the range expected were all pregnancies to deliver at any given gestational age. In this population of twins, the median birth weight was consistently lower than that reported for singletons, and there was variation in the median birth weight at different gestational ages according to chorionicity. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. - Legal Statement: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.23606

Twin chorionicity-specific population birth-weight charts adjusted for estimated fetal weight

Mean birth weight of twins is known to be lower than that of singletons, however, southern China lacks a twin-specific birth weight reference. In this paper, we use data from the Birth Certificate System in southern China, collected between January 1st 2014 and December 31st 2017 and including 161,076 twins, to calculate sex- and gestational week-specific birth weight percentiles (the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th). We applied generalized additive models for location, scale and shape (GAMLSS) when calculating the birth weight percentiles, and calculated percentiles for monochorionic and dichorionic twins separately. We next used data collected between Jan 1st 2018 and Apr 30th 2018, encompassing 12,371 live births, to calculate the SGA and LGA ratios using birth weight references in Australia, South Korea and China (based on birth defects surveillance system) and birth weight percentiles calculated in this study. Compared to dichorionic twins, monochorionic twins had lower birth weights at 25 to 42 weeks of gestation. The calculated SGA and LGA ratios were relatively stable compared to the other references.

/pdf/birth-weight-percentiles-by-sex-and-gestational-age-for-2niool2sr9.pdf

Birth weight percentiles by sex and gestational age for twins born in southern China.

Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India.

/pdf/birth-weight-centiles-by-gestational-age-for-twins-born-in-30jbz45zpo.pdf

Birth weight centiles by gestational age for twins born in south India.

Objective: To investigate the ability of sildenafil to inhibit the contractility of isolated non pregnant human myometrium. Materials and Methods: The inhibitory effect of three concentrations (3, 10, and 30 µM) of sildenafil on 55 mM KCl-induced contractility of isolated non-pregnant human myometrium was studied. The ability of the guanylyl cyclase inhibitor ODQ (10 µM), the adenylyl cyclase inhibitor MDL-12,330A (10 µM), the non-specific potassium channel blocker TEA (2 mM), and the calcium-sensitive potassium (BKCa) channel blocker iberiotoxin (100 nM) to reverse the inhibition of 10 µM sildenafil on KCl-induced myometrial contractility was also studied. Results: Sildenafil produced a concentration-dependent inhibition of KCl-induced myometrial contractility that was statistically significant at all three concentrations of sildenafil used. The inhibition by 10 µM sildenafil of KCl-induced myometrial contractility was not reversed by the concurrent administration of ODQ or MDL-12,330A. The inhibition of 10 µM sildenafil of myometrial contractility was partially reversed by concurrent administration of TEA and totally and significantly reversed by the concurrent administration of iberiotoxin. Conclusions: These results suggest that sildenafil inhibits the contractility of isolated non-pregnant human myometrium. The results suggest that sildenafil does so by opening BKCa channels.

Inhibition by sildenafil of contractility of isolated non-pregnant human myometrium

Diabetes is the most common condition in pregnancy with a worldwide prevalence of 16.9%. To determine the adequacy of the nutrient intake of pregnant women with diabetes mellitus. This is a cross-sectional study of 85 pregnant women who met the diagnostic inclusion criteria for diabetes mellitus (gestational and pre-gestational diabetes mellitus) and who were being managed at the outpatient clinic of a tertiary care teaching hospital. Their demography, clinical characteristics (from updated medical records), anthropometric measures (using standard procedures), nutrient intake and meal pattern (obtained using 24 h recall, food frequency and their log diaries) were collected. The mean age of the group was 29.9 + 4.5 years, 54% were in the second trimester of pregnancy with a mean glycosylated haemoglobin level of 6.3 + 1.4%. The mean BMI indicated that 47% of them were in the obese grade 1 category. Insulin was used in one-third of the population. The overall macronutrient and micronutrient intakes of the population were below the recommended daily allowances for Indians (60–70% of RDA). There was a deficit in the intake of calories, fibre, proteins, iron, calcium, carotene, folic acid, thiamine, riboflavin and niacin. Between the two groups, the pre-GDM women had a significantly better nutrient intake and this could be attributed to a greater exposure to nutrition counselling that they have received during the earlier part of their diabetes care. The gestational period should be viewed as a window of opportunity to modify dietary patterns and introduce healthy lifestyle practices for the woman and her family.

How Adequate are Macro- and Micronutrient Intake in Pregnant Women with Diabetes Mellitus? A Study from South India.

Introduction: Telocytes are an unique type of cells found in the interstitial tissue of various organs including the female reproductive tract. These cells are recently being implicated in various functions, including tissue repair and regeneration. They are associated with nerve endings, but their association with blood vessels and immune cells has not been established in the Fallopian tube unlike the telocytes seen in the uterus. This study aims to look for the association of telocytes with blood vessels and immune cells in the human postpartum Fallopian tube. Material and Methods: Ten postpartum Fallopian tube samples from the ampulla were obtained from the patients who underwent lower segment cesarean section with sterilization by the modified Pomeroy's technique. The samples were processed for electron microscopy and studied under a transmission electron microscope. Results: The human postpartum Fallopian tube showed increased microvasculature. Telocytes were found to be located in the mucosal and the muscular layers of the human postpartum Fallopian tube, predominantly in the subepithelial layer of the lamina propria. They were seen in association with blood vessels, especially high endothelial venules and immune cells such as mast cell and lymphocytes. Discussion and Conclusion: Telocytes seen in association with the blood vessels, especially high endothelial venules and immune cells in the human postpartum Fallopian tube suggest their probable role in the complex interplay in the immune tolerance and immune surveillance of the postpartum Fallopian tube.

Ultrastructural demonstration of telocytes in human postpartum Fallopian tube

Multiple gestations, especially monochorionic twins are associated with unique complications such as twin to twin transfusion syndrome (TTTS) and twin reversed arterial perfusion (TRAP) sequence due to preferential blood flow within the vascular communications between the two fetuses. TRAP sequence is a rare complication of monochorionic twins. The authors describe two cases of acardiac twins, one diagnosed at 17 weeks and the other at 24 weeks. While the first one was lost to follow-up, the second pregnancy was managed expectantly with close antepartum surveillance and had a term vaginal delivery of a healthy baby, along with the acardiac twin which was non-viable. The pump twin continues to be developmentally normal.

Santhosh Joseph Benjamin

Papers

Birth weight centiles by gestational age for twins born in south India.

Inhibition by sildenafil of contractility of isolated non-pregnant human myometrium

How Adequate are Macro- and Micronutrient Intake in Pregnant Women with Diabetes Mellitus? A Study from South India.

Ultrastructural demonstration of telocytes in human postpartum Fallopian tube

Acardiac Twin: A Report of Two Cases