Vocal cord dysfunction can be an easily overlooked complication after open heart surgery. It can be the cause of respiratory insufficiency following tracheal extubation and may lead to reintubation and reventilation. The cause of the problem cannot always be traced but it may be due to direct trauma of the vocal cords during tracheal intubation, or trauma of the recurrent laryngeal nerve from the cuff of the endotracheal tube. A less likely possibility is that it may result from nerve injury due to central venous cannulation, or from cold. The condition may resolve within months, but, in rare cases, may lead to permanent morbidity.

Introduction To determine the etiology of cases with organic erectile dysfunction (ED), invasive techniques are needed that can induce patient anxiety and disturb test results. Aim To find any special patterns of nocturnal penile tumescence and rigidity (NPTR) records in cases of vasculogenic impotence that can differentiate cases of arterial and venous origin without resorting to the more invasive diagnostic tests. Methods This study included 95 cases of ED (77 cases with abnormal NPTR records plus 18 cases with normal NPTR). History taking and clinical examination with estimation of serum androgen hormones and postprandial blood glucose were done. All patients were then subjected to the following: NPTR monitoring using RigiScan device (Dacomed Corporation, Minneapolis, MN, USA), pharmacopenile duplex ultrasound examination, and redosing pharmacocavernosometry. According to the results of these tests, patients were classified into four groups: psychogenic, arteriogenic, venogenic, and combined arteriogenic–venogenic ED groups. Receiver operator characteristic (ROC) curve analysis of the different RigiScan parameters of venogenic group vs. the arteriogenic group was done. Best parameters were then retested by using them in prediction of veno-occlusive dysfunction (VOD) in all studied patients. Main Outcome Measures Different RigiScan parameters: number of events, duration of best episode, base tumescence, base rigidity, tip tumescence, and tip rigidity. Results RigiScan parameters were statistically lower in venogenic than in arteriogenic group and were more correlated with flow to maintain than the peak systolic velocity. ROC curve analysis showed that VOD can be predicted if the duration of the best event is <11.5 minutes (diagnostic accuracy 83.7%) or tip rigidity is <36.5% (diagnostic accuracy 81.6%). On generalizing these values in all patients, duration of best event showed diagnostic accuracy of 88.4%. Conclusion VOD can be predicted if duration of the best event of NPTR monitoring is less than 11.5 minutes, but the presence of concomitant arterial dysfunction cannot be excluded.

The CAG repeat and its association with infertility has been debatable. Therefore, this study was planned to assess the distribution of CAG repeat expansion in Egyptian patients and to investigate its association with male infertility. Forty-five infertile men were eligible for the study in addition to 20 aged-matched fertile males as control. Semen analysis, scrotal sonography, assay of serum testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH), and determination of the CAG repeat number within exon 1 of the androgen receptor (AR) gene were carried out. Statistically significant difference was found between infertile and control groups regarding sperm count, sperm motility, serum FSH level and CAG repeats (P < 0.05); statistically insignificant difference for the CAG repeats (P = 1.0) was found between oligozoospermic and asthenospermic groups; negative correlation was found between CAG repeat length and sperm count, and a positive correlation was found between CAG repeat length and serum FSH (P < 0.05). Our results validate the concept that long stretches of CAG repeat may be associated with lower AR function with derangement of sperm production, and this may contribute to male infertility in Egyptian men.

Inguinal hernia impaired testicular perfusion that improved postoperatively. Lichtenstein tension-free hernioplasty improved sexual function and generic quality of life without adverse mesh effects on testicular volume or perfusion.

This study aimed to identify seminal Corynebacterium strains in infertile men with and without leucocytospermia. Semen samples from 60 infertile men were allocated into two equal groups: semen samples with leucocytospermia and semen samples without leucocytospermia. Semen culture for Corynebacterium species was carried out on Columbia agar medium confirmed by Gram-stained film and biochemical tests followed by analytical profile index biotyping and antibiotic susceptibility. Bacterial isolates were detected in 20/60 semen cultures (33.3%) as Corynebacteria, Staphylococci, Alpha haemolytic streptococci and E. coli. In all, 12/60 (20%) had Corynebacterium positive semen culture, whereas C. seminal was the major isolated species followed by C. amycolatum, C. jekium and C. urealyticum. There was nonsignificant difference between patients with/without Corynebacterium positive culture regarding sperm concentration and normal sperm morphology; however, in positive cultures sperm motility was significantly lower compared with negative cultures. Antimicrobial sensitivity among Corynebacteria strains was highest for vancomycin, rifampicin then imipenem, ampicillin + sulbactam, ciprofloxacin. It is concluded that positive semen cultures for different Corynebacteria species were demonstrated in infertile men, whereas Corynebacterium seminale was the most common isolated species. Vancomycin, rifampicin then imipenem and ampicillin + sulbactam are recommended as sensitive antibiotics.