ali hamidi madani

Varicocele is one of the most common treatable causes of male infertility, and its treatment may bebeneficial for fertility. This study aimed to evaluate fertility rate and DNA fragmentation index (DFI) following varicocelectomyin primary infertile men with clinical varicocele. This prospective longitudinal study was conducted on primary infertility men, in a tertiarycenter from December 2018 to December 2019 with one-year follow-up. Data of the semen parameters, DFI (%), andfertility rate were gathered before, as well as 4 and 12 months after undergoing varicocelectomy. For data analysis,SPSS software and analytical test were used. Out of 76 patients who were analyzed, 22 (29%) became fertile and 54 (71%) remained infertile. Semenparameters and DFI (%) were improved significantly following varicocelectomy (P<0.001). Smoking history, occupationalheated exposure, body mass index (BMI), and infertility duration were determined as predictors associatedwith fertility status (P<0.05). Although varicocele repair improved the DFI, the fertility rate was achieved in less than one-third ofpatients; it seems that the other parameters, such as the history of smoking, occupational heated exposure, overweight,and duration of infertility should be considered as predictors of fertility status, in primary infertile men who are a candidatefor varicocelectomy.

 Non-invasive treatments, such as low-intensity extracorporeal shock waves treatment (Li-ESWT), can be a safe and effective alternative for patients with erectile dysfunction (ED) who are resistant to phosphodiesterase type 5 inhibitors (PDE5Is).

 This clinical trial study aimed to evaluate the effect of Li-ESWT on ED in non-responders to PDE5Is, its durability, and factors predicting its success.

 This study was conducted on 128 patients with ED who were resistant to PDE5Is. Before any intervention, written informed consent was obtained, demographic characteristics were collected, and the severity of the ED score was determined using the international index of erectile function (IIEF). Patients were treated with Li-ESWT, and ED severity was remeasured by the IIEF scale at the end of the intervention, three months, and six months after the intervention. The data were analyzed by chi-square, repeated measure ANOVA, Bonferroni post hoc, and binary logistic regression tests.

 A total of 128 patients with ED who had not responded to PDE5Is, with a mean age of 58.35 ± 8.28 and an average ED of 3.41 ± 1.78 years, were included. At the end of the intervention, the IIEF score significantly increased. Moreover, this score was significantly higher three months and six months after the intervention. Three and six months later, the IIEF score decreased significantly. However, the score was significantly higher all three times than before the intervention. Being younger than 60 years, having an ED duration of fewer than three years, being non-smoking, being non-diabetic, and having no lower urinary tract symptoms (LUTS) were the most prominent predictors of a successful ED treatment.

 Low-intensity extracorporeal shock waves treatment is a safe and effective method for short and long-term treatment of ED patients. Identifying predicting factors can be beneficial for urologists in selecting suitable patients and avoiding the overtreatment of those who are not suitable candidates.

Varicocele is one of the leading causes of infertility in men. Resistance index (RI) in testis is a parameter indicating parenchymal perfusion and microvascular functions. Increased RI in the testis of patients with varicocele might be a sign of impairments in microvascularization and a significant decrease in testicular perfusion. In the present study, RI in capsular and intraparenchymal testicular arteries was evaluated in patients with varicocele who underwent varicocelectomy.

This prospective cohort study was performed in 2019-2020 in Guilan, Iran. Sixty-six patients were included. Semen analysis was also done before surgeries. Patients with at least one disorder in semen analysis entered the study. RI in testicular arteries was measured by an experienced radiologist before surgeries. Six months after varicocelectomy, all patients underwent the same semen analysis and ultrasound imaging. Data were analyzed using SPSS software. The tests for analysis included McNemar Test and Wilcoxon and p<0.005 was considered as the significance level.

According to the results, 42 patients (63.6%) had positive changes in sperm analysis after surgeries. Sperm analysis showed a significant increase in number, concentration, morphology, and motility of sperm after surgeries (p<0.001). Further measurements of capsular and intratesticular RI in all patients also indicated a significant decrease (p<0.001).

Increased RI might be associated with impaired microperfusion in testis followed by impairments in semen. Moreover, mean capsular and intratesticular RI in patients decreased after surgeries and this decrease was significantly more in patients who had improvement in their semen parameters.

Background and Female sexual dysfunction (FSD) is a high-frequent multifactorial problem and may have a major effect on the quality of life. This study was conducted to investigate frequency of female sexual dysfunction and its correlated factors in women attending outpatient gynecological clinics. A total of 300 married women attending four gynecological outpatient clinics in Rasht, Iran were assessed. Sexual function was evaluated through Female Sexual Function Index (FSFI) questionnaire. Demographic characteristics, obstetric and surgical history, some medical conditions and body mass index (BMI), life style variants, knowledge about sexuality, and help-seeking behavior were assessed by a self-created questionnaire. Statistical analysis included Fisher exact test Chi-square and Spearman’s correlation coefficients. 76.67% of all women in this study reported sexual dysfunction in at least one domain. The total frequency of FSD according to the low total FSFI score was 18.3%. The most frequent dysfunction was desire disorders (63.7%). The frequencies of other sexual disorders were as follows: pain disorders (35.7%), arousal disorders (34.7%), orgasmic disorders (16%), lubrication disorders (10.7%), and satisfaction disorders (10.7%). Age, number of deliveries, number of children, number of abortions, menopause, mode of delivery, episiotomy, anemia, psychiatric disease, psychotropic medication use, poor sexual knowledge, and husband’s age showed a significant statistical correlation with low total FSFI score. Women who thought they had a sexual problem involved 15.3% of all subjects, of which 67.4% have had no professional consultation about it. FSD is highly frequent in women referred to gynecological clinics. Thus, more attention to the state of women’s sexual health is recommended

Several medical therapies have been proposed for the treatment of premature ejaculation (PE). Paroxetine and tramadol were both reported to be effective in treatment of PE. In this study, the therapeutic effects of tramadol, paroxetine and placebo were compared in treatment of primary PE.
In this randomized, double-blind, placebo-controlled clinical trial, 150 patients were divided into 3 groups. One group was treated with tramadol 50 mg on- demand, the other group took paroxetine 20 mg on-demand and the third group was treated with placebo. Before starting treatment and after 12 weeks, patients were asked to measure their average intravaginal ejaculation latency time (IELT) and fill the PEP (Premature Ejaculation Profile) questionnaire.
At the end of the 12th week, the mean IELT and average of PEP scores improved in all 3 groups. The increase in tramadol group was significantly higher than the paroxetine and placebo groups (p The results showed that despite an increase in mean IELT and PEP scores in all 3 groups, the rate of improvement in tramadol group was significantly more than the others. Thus, tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE.

Chromatin Epigenetic changes have a key role in pathophysiology of prostate cancer. The most important epigenetic changes are change in DNA methylation, histones modifications, changes in chromatin status and micro RNAs regulatory patterns which are related to tumor creation. Histone deacetylases (HDACs) comprise a large family of enzymes which act as key regulators of nucleosomal histone consistency. HDACs have a great role to start and develop prostate cancer which is due to changes they create. Epigenetic modifications, in particular DNA hypermethylation and histone acetylation have an essential role in the regulation of genes that protect against prostate cancer. Since epigenetic changes are reversible, they are interesting targets for cancer therapy. Many epi-drugs such as histone deacetylase inhibitors (HDACi) show anti-cancer properties in either cell culture or in the animal models of prostate cancer.
In this case-control study, RNA extraction was performed on samples then the expression of HDAC1 in human prostate cancer using reverse-transcription polymerase chain reaction (RT-PCR). This study was conducted comparing 20 patients diagnosed with prostate cancer to 20 disease free control subjects.
Findings: Our findings suggest that the expression of HDAC1 mRNA is tangible and a significant difference was observed between patients and control subjects.
Discussion & These results imply that HDAC1 mRNA expression could have potential as a marker and may have prognostic implications for Prostate cancer progression.

Isolated renal hydatid disease is a rare endemic infestation caused by larval form of Echinococcus granulosus. Hydatiduria is an uncommon presentation of renal hydatid disease. In 2012 a 34-year-old female referred to Razi Hospital, Rasht, Iran with complaints of right flank pain and grape-like material in urine. Diagnosis was made by ultrasonography and CT scan. The patient was treated surgically with nephrectomy in combination with perioperative chemotherapy with albendazol.

Rhabdomyolysis and secondary acute kidney injury caused by myoglobin – induced acutetubular necrosis is a rare but serious complication of incorrect position. Obesity andprolongation of surgery are the most important risk factor of rhabdomyolysis. In this case we discuss a 80 years old man complicated after TURP in standard lithotomy position. raise in BUN, Cr, and CPK was happened in second day after surgery. The patient has been diagnosed as rhabdomyolysis and treated conservatively there is no need to dialysis and finally discharged from hospital in fifth day after surgery.

Inguinal bladder hernia is a rare clinical condition, with 1–3% of all inguinal hernias involving the bladder. Any portion of the bladder may herniate, from a small portion or a diverticulum to most of the bladder. We present a 55-year-old male with an intermittent right scrotal mass of 6 months’ duration. The mass lesion protruded through the right inguinal canal before voiding and reduced after that. Scrotal sonography revealed a hypoechoic lesion in the scrotum that stretched cranially to the intra-abdominal portion of the bladder. Excretory urography showed a duplicated system in the left kidney and deviation of the left orifice to the right side of the trigon. Finally, cystography illustrated herniation of the bladder to the right scrotum. Surgical repair of the hernia was done with mesh. Follow-up cystography one month postoperatively revealed no herniation.

Background and Development of the male phenotype and the initiation of spermatogenesis are intricately dependent on the cellular events that respond to androgens. The actions of androgens are mediated by the androgen receptor (AR). The aim of this study was to investigate the association of AR 5'UTR and codon 211 genetic variation with the risk of idiopathic male infertility. Genomic DNA was extracted from 60 men with idiopathic infertility and 70 healthy men. The genetic variation of 5'UTR and codon 211 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)- and PCR-single strand conformation polymorphism (SSCP), respectively. No mobility shift was seen in the PCR products of 5'UTR in patient and control groups. We did not identify a single mutation at 5'UTR of AR gene in patients and controls. Genotype frequencies of codon 211 in patient group were GG (67%), GA (23%), AA (10%) and in control group there were GG (77%), GA (21%) and AA (1%). No significant differences were found between the two groups in allelic frequencies (χ2=2.40; P=0.3). Our findings suggest no correlation between these polymorphisms and male infertility in the studied patients. However, further studies of AR polymorphisms with their biological functions are needed to understand the role of these polymorphisms in the development of male infertility.