Introduction: Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Bypassing health-care providers and obtaining ED medications (EDM) without a prescription are an issue that is faced globally. Aim: We attempt to assess erectile function (EF) among a local sample of physicians, the psychological effects of recreational EDM use, and compare EF among different user groups. Methods: This is a cross-sectional study done solely on physicians in Saudi Arabia. A self-designed questionnaire including demographics, sexual characteristics, use of ED medication, sexual satisfaction, and the validated international index of EF (IIEF). Outcome: Physicians misused EDM. Results: A total of 503 physicians completed the questionnaire. Among participants reporting sexual problems, only 23% received counseling and 3.4% were professionally diagnosed with ED. Among users, 71.2% were using EDM recreationally, 14.4% prophylactically, and 14.4% were prescribed. Participants aged 20–29 IIEF-5 score was significantly lower than participants aged 30–39 years. Prescribed users had a lower IIEF-5 score compared to both recreational users and nonusers. Clinical Implications: Many healthy sexually active men use EDMs recreationally to increase sexual performance. Strengths and Limitations: One of the limitations of our study is that we did not use standardized tools to determine the diagnosis of some important disorders like premature ejaculation. Our study strengths include the very high response rate, with our results truly showing a nationwide self-assessment of sexual dysfunction. Conclusion: Recreational use of oral EDMs may adversely impact the psychological aspects of sexual function. In our study, physicians misused EDM. We recommend labeling EDMs as restricted medication that requires a prescription to use by a licensed physician.

Restless leg syndrome (RLS) is a disorder affecting a significant portion of the general population. The syndrome has a strong family component and several comorbid conditions may be associated with RLS. Researches over the past 10 years had highlighted its heritability and had shed some interesting light to this disorder. Restless legs syndrome (RLS), or Willis-Ekbom disease, is a neurological disorder that is characterized by unpleasant or painful sensations in the legs and a distressing, irresistible urge to move them. RLS symptoms worsen during inactivity and at night. Partial or complete relief may result from movement such as walking, stretching, or bending of the legs. Yet, the relief is often temporary and symptoms return when movement ceases. Aim of the work: this study aimed to evaluate the prevalence and associated factors of restless leg syndrome among Medical Students at University of Tabuk. Methods: we have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. The study was conducted during the period from July to December 2017. The participants who attended the college of medicine at university of Tabuk were included in the study. The total sample obtained was 151. A self-administered questionnaire about restless leg syndrome was filled by the participants. Results: age of the participants was ranged from 18 to 27 years old, with a mean (SD) of 22.72 (1.837), the majority were 6 th year medical students (39.7%). 39.7% reported that they had urge to move the legs with unpleasant sensations in the legs, from those who reported they had urge to move the legs with unpleasant sensations in the legs, 80% of them reported that it is relieved by movements. Conclusion: more attention is needed on recognition of RLS among medical students and to manage the aggravating factors of RLS.

Introduction:Percutaneous nephrolithotomy (PCNL) is still the mainstay and the treatment of choice for most complex renal stones. The success of PCNL is defined by achieving a stone-free rate (SFR). Lower calyceal access PCNL is established to be the safest percutaneous access to the renal system, but controversy is present when it comes to SFR in comparison to upper calyceal and middle calyceal accesses.Aim:We aim to prove that lower calyceal access PCNL is the safest PCNL access and has the same efficacy as upper calyceal access PCNL for staghorn stones.Methodology:All lower calyceal access PCNLs done from May 2012 to August 2017 were included in the study. Postoperative complications were reported using the modified Clavien Grading System.Results:Sixty-seven patients were included in the study. The mean age was found to be 49.39 years; most (36 [53.73%]) patients were male. The prevalence of diabetes, hypertension, dyslipidemia, and chronic kidney disease was 40.91%, 47.76%, 37.31%, and 20.00%, respectively. The mean hospital stay was 7.9 days; mean operative time was 138.52 min. The mean staghorn stone burden was 476.34 mm2. About 80.59% (n = 54) of patients had complete stone resolution after the first session. Only 3 (4.47%) patients had complications and classified as Grade 2 on the modified Clavien Grading System and the remainder were classified as Grade 1, two patients needed postoperative blood transfusion, and one had a renal pelvis perforation.Conclusion:When it comes to safety and efficacy, the use of lower calyceal single-access PCNL has a very low complication rate compared to upper calyceal access PCNL, especially pneumothorax and bleeding.