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Benign Prostatic Hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms in men [1].

Sexual addiction is a growing reality. The acknowledgment of this disorder requires to identify vulnerability factors. Besides, it would improve the management and treatment of these people. We used a cross-sectional study with a sample of voluntary subjects recruited online anonymously. A prepared questionnaire explored the general and clinical data of the sample. The psychometric scales used were: Carnes Sexual Addiction Screening Test, the French Big Five Inventory for personality dimensions and the Rosenberg Scale for self-esteem. Five hundred and ten individuals were included. 38 people (8%) had sexual addiction. 68 people (13%) had attenuated symptoms of sexual addiction. The average age of the group with sexual addiction was 30.8 years with a male predominance. The majority had a higher academic level, was single (39.5%) and are working (73.7%). Our study revealed that self-esteem was below average in 73.7% of people with sexual addiction. Concerning personality dimensions, individuals with sexual addiction had higher scores in Neuroticism. The analytic study showed that four variables were statistically correlated with sexual addiction: male sex; low self-esteem; a large N dimension and a low C and E dimension. The concept of sexual addiction, still poorly defined, is beginning to be recognized. The need for more research is required to identify the factors of vulnerability with the aim of developing the preventive axis and improving the quality of life.

Objective: This study aimed to investigating of the epidemiological aspects of infertility and related risk factors in infertile women. Materials and methods: This cross-sectional study, carried out on 330 infertile women referred to two infertility treatment center of Imam Khomeini Hospital and Mother center in Sari, Iran, from April 2015 to March 2017. Results: 54.5% of these women were in the age of 30-39 years, infertility duration in 55.2% was 1-5 years, Body mass index (BMI) in 44.5% of samples was 26-30 kg/m2, 54.5% had diploma and associate degree. 63.6% lived in urban areas. 74.5 % of patients reported primary infertility. History of polycystic ovarian syndrome (PCOs) and pelvic inflammatory disease (PID) and poor ovarian reserve were the most common causes and risk factors for the infertility with prevalence 19.42%, 16.81% and 13.91%, respectively. Most underlying disease was thyroid disorders (54.5%). There was found statistically significant relationship between residents of urban areas and infertility duration, endometriosis and educational levels, miscarriage with thyroid. Data analysis performed using IBM SPSS 21 software and Chi-Square test (p < 0.05). Conclusion: The results showed that women with infertility in north of Iran were more likely to be older, less educated, and also had overweight. They are more possible to have ovarian disorders. In these area, thyroid disease more common like Iodine deficient regions. Future research should be focused on the reasons why majority of women don’t seek treatment for the underline significant diseases that may be effects on ovarian function and fertility.

Purpose: The purpose of the study was to examine the health status of rural adolescents and young adults in the United States through a comprehensive review of detailed health information, behavior and health awareness. The disparity in health awareness between rural and non-rural residents compared and evaluated. Methods: Rural-Urban Commuting Area (RUCA) codes were combined with respondent-level data from the Longitudinal Survey of Adolescent to Adult Health (Add Health) to classify individuals as rural/non-rural residents. Health characteristics and perceived health awareness was tested for statistically significant differences using ANOVA. Differences in weight perception accuracy was compared for systematic differences controlling for self-selection into rural areas using a two-stage logistic selection model. Findings: Analysis revealed that rural residents have a higher incidence of major health conditions including epilepsy, high cholesterol, high blood pressure and diabetes. Additionally, they have a higher prevalence of unhealthy behaviors including drinking and drug use. Rural residents are less likely to be insured, but more likely to be overweight or obese. While rural adolescents are more likely to mis-classify their body weight, this misclassification is a result of the higher incidence of overweight rather than the residential location. Conclusion: The higher prevalence of chronic conditions combined with the income and education levels suggests the rural environment is a unique and potentially challenging context for adolescent health. Improving rural adolescent health will require innovative solutions appropriate for rural environments and changes in individual health literacy. Solutions must be multisectoral, engaging education, economic development, and other community perspectives to establish key drivers for health equity.

Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously.Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients.Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted).

Aims: To examine patient satisfaction of an outpatient operative hysteroscopy performed by both doctors and nurse hysteroscopists. Secondly, compare satisfaction, complications, and failure rate of these procedures performed by doctors and nurse hysteroscopists.Methods: In this retrospective study, the charts of 80 women who attended the service over one year were examined. Women were included if either an endometrial polyp or submucosal leiomyoma required removal using an endoscopic morcellator. All women had signed a consent form for the procedure. Results: In total 67/80 (84%) patients were satisfied with the service. Nurse hysteroscopists completed most procedures 59/80 (74%). Satisfaction ratings were not recorded for 13/80 (16%) consultations, completed by doctors. There was no difference in satisfaction and complication rates between doctors and nurse hysteroscopists. A total of five patients required repeat endoscopic morcellation, three completed by doctors and two completed by nurse hysteroscopists. For this group, satisfaction and complication ratings did not change.Conclusion: High patient satisfaction and low complication rates were found. Nurse hysteroscopists performed more procedures, providing a safe and useful service. Few patients required repeat morcellation procedures.

Introduction: Preeclampsia constitutes a public health problem in our region. According to the WHO, it is the third cause of maternal mortality after severe hemorrhages, infections and is responsible for morbidity and high fetal mortality. The aim of this study was to improve on the management of severe preeclampsia at the University Hospital Center of Mother and Child (UHCMC) in N’Djamena.Patients and method: It was a prospective and descriptive survey of 3 years duration, from January 01st, 2017 to December 31st, 2019. Included in our study were, all patients admitted for severe preeclampsia and agreed to participate in the study. Epidemiological, clinical, therapeutic and prognostic studies were conducted. The data collected was analyzed using SPSS 18.0 software.Results: During the study period, 13599 pregnant and parturients were admitted to the Gynecology-Obstetrics department of the UHCMC, among whom 406 cases of severe preeclampsia, with a frequency of 2.9%. The patients were young (23.2 years), married (96.3%), primipara (61.3%), referred (64.3%) without antenatal care in 47.9% of cases. Functional signs were dominated by headaches with 34.0% of cases. The proteinuria was ≥ 3 crosses in 83.7% of cases. Patients had received magnesium sulfate in 98.3%, the delivery mode was cesarean in 64.0% of cases. Principal morbidity was eclampsia (40.8%) and fetal was prematurity (36.4%). Maternal lethality was 11.1% and fetal mortality was 19.9% cases.Conclusion: Severe preeclampsia is frequent in the UHCMC in N’Djamena. It is responsible for high maternal and fetal mortality. The practice of quality antenatal care, could prevent the occurrence of complications and improve the maternal-fetal prognosis.

Introduction: Preparing a report and passing certification for a qualification category is one of the forms of improving the professional level of each medical worker.Material and methods: The analysis of 5 qualification works of a psychiatrist (1997, 2002, 2008, 2013, and 2018) was carried out for the mandatory requirements for the preparation of documents when they were submitted to the Attestation Commission on the assignment of a qualifying medical category in psychiatry and formation methodological approaches to their implementation. The depth of research was 27 years.Results: Methodological approaches to the design of 11 mandatory sections provided for in the certification work of a psychiatrist presented for the award of a qualification category were considered.Discussion: The attitude to the Administrative Regulations for the provision of state services for the assignment of a qualification category to specialists engaged in medical and pharmaceutical activities should be revised in terms of its synchronization with the official duties of a doctor.Conclusion: The dynamic development of the regulatory, organizational, methodological, and scientific aspects of medicine and psychiatry, in particular, in the period of active digitalization of healthcare, requires periodic corporate discussion and correction of the Administrative Regulations for the provision of public services for assigning a qualification category to specialists engaged in medical and pharmaceutical activities.Attention should be paid to the insufficient statistical processing of the submitted materials by applicants for the assignment of the 1st and highest categories, the lack of calculations, references, and comparisons of confidence intervals, and the reliability of the study.Preparing a report and passing certification for a qualification category can be the first step in introducing a practitioner to scientific work through the generalization of personal work experience, worthy of speaking at a scientific and practical conference at the level of LU and the region and publishing abstracts in collections and scientific and practical journals.The proposed methodological approaches are purely advisory in nature and can be used by psychiatrists when working on a qualification category at their discretion.

Alcohol drinking habit is a serious epidemic that afflicts people worldwide regardless of socioeconomic class and the country’s development or civilization. The purpose of this systematic review was to summarize research findings on drinking and driving, its implications for Nigerian society, and the role forensic science can play in drunk driving. Nigeria, in particular has seen a lot of fatal accidents attributed to alcohol but due to a lack of forensic sobriety and toxicology drug tests at the crash scene that is not yet in place in the country, the offenders are not punished for this crime. The only two African countries that have legislation on Blood Alcohol Concentration (BAC) are South Africa and Zimbabwe. Nigeria has no such legislation and does not conduct such tests in injury and fatal accident cases. The prevalence of drinking habits among Nigerians and in particular the drivers cannot be ignored. This study examined global drinking habits including its prevalence in Nigeria and more importantly understudied the need for forensic science interplay in a criminal investigation against drunk driving in the country. Drunk driving in Nigeria is a serious problem. Establishing and enforcing drunken driving laws as a criminal offense would assist the country in the reduction of road accidents, injuries, and fatalities relating to road accidents. Forensic science is a unique field that is equipped with skills and knowledge that could be useful for criminal investigation in the country including accident cases. Forensic scientists have outstanding technical skills to identify, detect, and even assist the country’s prosecutors in the administration of justice in crime investigations. Nigeria as a country will be well served if forensic scientists work in partnership with the government. Drinking and driving in addition to other crimes has become a matter of concern. The country’s police force and courts still rely mostly on eyewitness circumstantial evidence, testimonies, and suspects’ confessions. Based on this, I personally believe that the advent of Forensic science in the country’s system will assist a great deal in solving crimes and reducing fatal accidents due to drunk driving.

We present a case of a 54-year-old White man who was admitted to our clinic for evaluation of gastroparesis. His gastroparesis was severe and unresponsive to previous treatments. Darkfield microscopy revealed the presence of spirochetes and corkscrew-shaped bacteria; although Lyme immunoglobulin M (IgM) and immunoglobulin G (IgG) Western Blot testings were negative. The patient was diagnosed with Chronic Lyme disease and recovered with antibiotherapy. We outline a rare case of dysmotility syndrome; a unique presentation of cChronic Lyme disease and emphasize the limitation of tools necessary in diagnosing Lyme disease