Middle-aged Males Research Articles

Primary Hepatic Burkitt Lymphoma

The liver is an uncommon primary site for lymphoma, comprising only 0.4% of extranodal lymphomas, and liver involvement is almost always secondary to systemic lymphoma. Primary hepatic lymphoma has been reported to occur more frequently in immunosuppressed patients, especially with chronic hepatitis C infection, and may be associated with hepatitis B infection and the Epstein-Barr virus. Patients usually present with pain or a mass in the right upper quadrant, with or without jaundice, and it is more common in middle-aged males. The diagnosis of extranodal lymphoma or primary hepatic lymphoma can be difficult, especially in people living with human immunodeficiency virus (HIV) positivity or acquired immunodeficiency syndrome (AIDS). Due to its rarity, it is often overlooked as a possible differential diagnosis, with nonspecific imaging findings and a definitive diagnosis made only after anatomopathological and immunocytochemical examination. We present a rare case of Burkitt's lymphoma presenting as liver masses.

Sudden death related to sexual activity: A multicenter study based on forensic autopsies (2010–2021)

Introduction and objectivesTo investigate the epidemiological characteristics, clinic-pathological findings and recent use of substances of abuse and prescribed drugs in sexual activity-related sudden death (SArSD). MethodsMulticenter population-based study on forensic autopsies conducted in 27 provinces of Spain over 12 years (2010–2021). ResultsOut of 18046 autopsied natural deaths, 64 cases (0.35 %) of SArSD were investigated (87 % males). Women were younger than males (50.5 ± 13.4 years vs 37.2 ± 14.2; p = 0.017). Sudden cardiac deaths (SCD) accounted for 87 % of cases. Ischemic heart disease was the predominant pathology (58 %), mainly affecting men ≥ 36 years of age. Cerebral haemorrhage (8 %) and asthma (5 %) were the leading non-cardiac causes. In young adults, SADS (36 %) and asthma (27 %) were the main causes The disease responsible of SCD was diagnosed in life in 7 subjects. In 64 % there were cardiovascular risk factors, mainly obesity. Toxicological analysis detected illicit drugs (23 %), mainly cocaine, medications for erectile dysfunction (9 %), and ethanol ≥ 0.5 g/L (8 %). Deaths occurred usually in the context of heterosexual intercourse and during or immediately after sexual activity. The most common location was at home (63 %). In 12 men the sexual partner was a sex worker. ConclusionsSArSD has a low incidence in the general population affecting middle-aged males during intercourse with a heterosexual partner. It is of cardiovascular origin, mainly due to ischemic heart disease that frequently remained silent during life. There is a frequent association with obesity, use of cocaine (and, to a lesser extent, medications for erectile dysfunction) and performing unconventional sexual practices. Forensic investigation is useful for developing prevention strategies.

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports.

Though increasing studies reported the management of spontaneous isolated celiac artery dissection (ICAD), the characteristics and etiology of ICAD in different age-stage patients have not been well-studied. Our study was designed to describe and further to compare the clinical features of spontaneous ICAD between young and old patients. We searched PubMed, Embase, and Web of Science up to March 1, 2023 for spontaneous ICAD case reports. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently. Statistical analysis was performed using SPSS software (version 19.0; IBM Corp, Armonk, NY) and Stata 12.0 (Stata Corp., College Station, TX). Descriptive results were presented as the mean ± standard deviation or percent. The comparison results between young and old patients were displayed as risk ratio (RR) or standardized mean difference (SMD) with its 95% confidence intervals (CI). We totally identified 60 reports in the present analysis. The mean age of patients was 52.4 years, with the majority of patients being male (84.4%). The majority of patients were symptomatic and commonest presentation was abdominal pain (76.7%). Most patients (63.2%) had comorbidities or history and hypertension and smoking were the top 2 conditions with proportion of 63.3% and 40.5% respectively. When comparing young to old patients with ICAD, no significant difference was found in demographic and clinical features including sex, comorbidities/history, and symptoms. However, we found that young patients with ICAD experienced significantly longer dissection length (SMD 1.01, 95% CI 0.16-1.86; P = .015) and distance from ostium (SMD 0.96, 95% CI 0.07-1.85; P = .013), but no significant difference was observed in true lumen compression (SMD -0.39, 95% CI -1.22-0.44; P = .364). In addition, our results showed that ICAD in young patients extending more to distal arteries, including common hepatic artery/hepatic artery (RR 2.04, 95% CI 1.13-3.68; P = .01), splenic artery (RR 2.36, 95% CI 1.24-4.49; P = .017) and left gastric artery (RR 25.42; 95% CI 1.55-417.74; P = .04). Though spontaneous ICAD had multitudinous clinic-pathologic features, it was apt to middle-aged males and symptomatic and abdominal pain was always the commonest presentation. Hypertension and smoking were the top 2 conditions of ICAD patients. There was significant difference between young and old patients in radiographic characteristics of ICAD which may lead to different treatment and outcomes.

Targeting Longevity Gene SLC13A5: A Novel Approach to Prevent Age-Related Bone Fragility and Osteoporosis.

Reduced expression of the plasma membrane citrate transporter SLC13A5, also known as INDY, has been linked to increased longevity and mitigated age-related cardiovascular and metabolic diseases. Citrate, a vital component of the tricarboxylic acid cycle, constitutes 1-5% of bone weight, binding to mineral apatite surfaces. Our previous research highlighted osteoblasts' specialized metabolic pathway facilitated by SLC13A5 regulating citrate uptake, production, and deposition within bones. Disrupting this pathway impairs bone mineralization in young mice. New Mendelian randomization analysis using UK Biobank data indicated that SNPs linked to reduced SLC13A5 function lowered osteoporosis risk. Comparative studies of young (10 weeks) and middle-aged (52 weeks) osteocalcin-cre-driven osteoblast-specific Slc13a5 knockout mice (Slc13a5cKO) showed a sexual dimorphism: while middle-aged females exhibited improved elasticity, middle-aged males demonstrated enhanced bone strength due to reduced SLC13A5 function. These findings suggest reduced SLC13A5 function could attenuate age-related bone fragility, advocating for SLC13A5 inhibition as a potential osteoporosis treatment.

A Case Report on Kimura Disease

Introduction 
 Kimura disease is a rare chronic inflammatory disease that, if occurs in the head and neck region, presents with a swelling. 
 Case Report 
 A 14-year-old male presented to our ENT OPD with a painless left cheek swelling. The swelling was first noticed by the patient about 3.5 years back. The swelling was gradually progressive in size. It was mobile in all directions, cystic in consistency and non-tender. 
 Discussion 
 Kimura Disease is a rare chronic inflammatory disorder described as a”eosinophilic hyperplastic lymphogranuloma” in Chinese literature. This disease is endemic in middle-aged Asian males and is seen sporadically in the non-Asian population.There is no standardized treatment protocol present for Kimura Disease. Treatment modalities include surgical resection, cytotoxic and radiation therapy, as well as regional or systemic steroid therapy. The role of surgery is primarily for diagnostic and cosmetic purposes. Relapses are common and recurrence rate is high. The overall outcome is good as there is no association with malignancy.

Manejo anestésico do felino obstruído: Relato de caso

Feline Lower Urinary Tract Disease (FLUTD) is the main cause of urethral obstruction in this species, including idiopathic obstructions, urethral plugs, urolithiasis and other mechanical obstructions, such as strictures and neoplasms. This predominance is directly related to young and middle-aged males, due to the male's urethra being longer and narrower, increasing the likelihood of interference. Clinical signs often include hematuria, polyuria and, most importantly, stranguria, along with a full bladder. In more severe cases, cardiovascular instability and azotemia may occur. The diagnosis of FLUTD is made through a physical examination of the patient, which may reveal bladder dilation, a history of difficulty urinating, with several visits to the litter box, and there may or may not be vocalization. The goal of work is to report a case of urethral obstruction in a fertile male feline, 2 years old, weighing 5 kg, complaining of probable constipation. During physical examination, the patient presented a lot of pain upon abdominal palpation, which led to sedation for a more detailed examination, revealing a full bladder with apparent stiffness. An anesthetic and therapeutic protocol was implemented to carry out the necessary procedures and monitor the evolution of the case.

Environmental Causes of Idiopathic Pulmonary Fibrosis.

Idiopathic pulmonary fibrosis (IPF), the most common and severe of the idiopathic interstitial pneumonias, is a chronic and relentlessly progressive disease, which occurs mostly in middle-aged and elderly males. Although IPF is by definition "idiopathic", multiple factors have been reported to increase disease risk, aging being the most prominent one. Several occupational and environmental exposures, including metal dust, wood dust and air pollution, as well as various lifestyle variables, including smoking and diet, have also been associated with an increased risk of IPF, probably through interaction with genetic factors. Many of the predisposing factors appear to act also as trigger for acute exacerbations of the disease, which herald a poor prognosis. The more recent literature on inhalation injuries has focused on the first responders in the World Trade Center attacks and military exposure. In this review, we present an overview of the environmental and occupational causes of IPF and its pathogenesis. While our list is not comprehensive, we have selected specific exposures to highlight based on their overall disease burden.

Real world utilisation of doravirine among people living with human immunodeficiency virus in England (DRIVE-REAL).

Doravirine is a non-nucleoside reverse transcriptase inhibitor recommended for the treatment of virologically suppressed and treatment naïve people living with HIV. The DRIVE-REAL study aimed to describe the characteristics, treatment patterns, and virological outcomes of doravirine users in a real-world cohort in the UK. A retrospective, observational, multi-centre chart review was conducted for 300 adults living with HIV initiating doravirine-containing antiretroviral therapy. At baseline 83% of individuals were male, 45% aged ≥50years, 65% white ethnicity. Median time since HIV diagnosis was 12years. 96% were antiretroviral therapy-experienced, 87% had a HIV viral load <50 copies/ml, and 15% had resistance to at least one antiretroviral drug. 66% had comorbidities, most commonly depression (26%), and 70% were taking at least one co-medication. At six months, 94% (n = 283/300) were still receiving doravirine. Viral load data were available for n = 266/300 individuals and 95% (n = 253/266) had viral load <50copies/ml. Individuals initiating doravirine in this cohort are predominantly treatment-experienced white middle-aged males, with a high frequency of comorbidities and co-medication. The majority of individuals at 6 months remained on doravirine and maintained or achieved HIV viral suppression. This study provides epidemiologic characteristics that can inform clinical care and subsequent hypothesis-testing studies.

Ten-year risk assessment for cardiovascular diseases using ASCVD risk estimator plus: outcomes from hypertension and diabetes patients

BackgroundCardiovascular risk prediction models encompass numerous CVD risk factors. Available prediction models were developed from non-Asian cohorts hence we decided to evaluate the performance of the ASCVD risk estimator model and the associated 10-year CVD predisposing factors in Punjab.MethodsWe carried out a cross-sectional study among patients having hypertension and diabetes mellitus in a tertiary hospital in Punjab, India. 201 participants without ASCVD who were ≥ 40 years old and had been admitted to the medical ward were assessed. a pre-validated questionnaire was used to collect data on the socio-demographics and behavioral patterns. Lipid profile and blood pressure measurements were collected as per standard protocols. The respondents’ CVD risk was assessed using ASCVD Risk Estimator Plus. Data were analyzed using IBM SPSS version 26; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVD at a 5% level of significance.Measurements.We examined the stratification of the predicted outcomes and evaluated the associations between individual risk factors and the predicted cardiovascular events. Our study categorized the results of these outcomes into 4 categories: low category (1–5%), borderline category (6–9%) intermediate category (10–20%), and high category (21–95%).ResultsOut of the 201 participants that enrolled in our study, the majority 76 (37.8%) were in the intermediate category, 56 (27.9%) were in the high category, 41 (20.4%) were in the borderline category, 28 (13.9%) were in the low category. The median ASCVD percentage was 14.20%. Respondents who were alcoholics, smokers, and drug abusers (OR = 5.8, 95% CI 0.397–83.584) were associated with the highest likelihood of developing CVDs. Furthermore, males had a significantly higher mean predicted CVD outcome % (M = 23.18%) compared to females (M = 14.91%).ConclusionAccording to our prediction study, it was discovered that 145 (72.1%) participants were not likely to have had an ASCVD in the next 10 years. However, middle-aged males should be more cautious with their lifestyle habits, particularly in dealing with risk factors that can expose them to CVDs.

The burden of neck pain in the Middle East and North Africa region, 1990–2019

BackgroundNeck pain is a common cause of disability across the world. The objective of the present study was to present a thorough investigation of the burden caused by neck pain in the Middle East and North Africa (MENA) region, by country, sex, age group and socio-demographic index (SDI). MethodsThe data on the burden of neck pain, encompassing its prevalence, incidence and years lived with disability (YLDs), were extracted from the Global Burden of Disease (GBD) 2019 study. These findings are reported as age-standardised numbers and rates (per 100,000), accompanied by 95 % uncertainty intervals (UIs). ResultsThe age-standardised point prevalence of neck pain in 2019 was 3066.7 (95 % UI: 2407.8 to 3894.3) per 100,000, with an age-standardised incidence rate of 649.2 (509.2–829.2) in the MENA region, neither of which have changed since 1990. The age-standardised YLD rate of neck pain was 303.0 (201.5–438.8) per 100,000 population in 2019. The highest YLD rate of neck pain was found in Iran [423.5 (280.3–609.8)] and the lowest in Kuwait [215.0 (141.0–314.1)]. The highest number of prevalent cases were seen in the 45–49 age-group for both sexes in 2019, but overall females had a higher point prevalence than males. Furthermore, over the study period (1990–2019) there was no clear and consistent relationship between the SDI and the burden of neck pain. ConclusionAlthough the burden of neck pain has largely remained stable over the past three decades, the prevalence and morbidity in the MENA region remains high. Preventive and rehabilitative programs should be implemented that firstly target middle-aged females and males.

Circulating Selenium Level Was Positively Related to Visceral Adiposity Index with a Non-linear Trend: a Nationwide Study of the General Population.

Selenium plays a role in obesity. However, whether circulating selenium levels are related to the visceral adiposity index (VAI), an indicator of obesity, is still unknown. Based on the National Health and Nutrition Examination Survey (NHANES) 2011-2018, data from 12,777 individuals aged ≥ 20 years were analyzed to clarify this question. In fully adjusted models of multivariate regression analysis, natural logarithm (Ln) selenium was positively related to Ln VAI (β = 0.41; 95% confidence interval [CI], 0.27, 0.55; P < 0.001). Compared with the lowest quartile of Ln selenium, the highest quartile was also positively associated with Ln VAI (β = 0.16; 95% CI, 0.11, 0.21; P < 0.001). Moreover, we found that this positive connection was non-linear. When Ln selenium was less than the inflection point, Ln selenium was positively related to Ln VAI (β = 0.41; 95% CI, 0.31, 0.52; P < 0.001). However, when Ln selenium was greater than or equal to the inflection point, Ln selenium was not significantly related to Ln VAI (β = -0.15; 95% CI, -0.56, 0.25; P = 0.455). In subgroup analysis, significant interactions were observed with age and sex (P for interaction < 0.05). Stronger interactions were observed among middle-aged participants (β = 0.65; 95% CI, 0.31, 0.98; P = 0.002) and males (β = 0.61; 95% CI, 0.43, 0.79; P < 0.001). Overall, circulating selenium levels were positively related to VAI, with a non-linear trend. Prospective studies and interventional experiments are necessary to verify the possible mechanisms.

Diagnosis and Management of Intrascrotal Nerve Tumors: A Systematic Review of the Literature.

Scrotal tumors of nerve origin are extremely rare and occur mostly in the extratesticular tissues of scrotum, such as the spermatic cord and epididymis. A systematic search of the literature in PubMed, Medline, and Google Scholar databases concerning intrascrotal nerve tumors was performed by 2 independent investigators. The systematic search retrieved 45 male adults, with a mean age of included patients at 43.9 ± 18.8 years. The majority of nerve tumors were extra-testicular (86.7%), and only 13.3% originated from the testis. Out of that, 51.1% of neoplasms were histologically proved as schwannomas, 44.4% as neurofibromatosis, and 4.4% as malignant peripheral nerve sheath tumors. The majority of patients presented with atypical symptoms such as scrotal swelling (51.1%), while only 4.4% of patients were asymptomatic. Ultrasonography is the diagnostic modality of choice (97.2%) for the detection of primary lesion, while magnetic resonance imaging and computed tomography comprise supplementary diagnostic tools. Surgical excision of the mass was the preferred type of surgery performed (75.6%), whereas orchiectomy was performed only in 22.2% of patients. Intrascrotal tumors of nerve origin are extremely rare neoplasms that present mainly in middle-aged males. Increased clinical suspicion is required for accurate diagnosis of this rare entity.

White matter changes in young and middle-aged males with chronic prostatitis/chronic pelvic pain syndrome: Tract-based spatial statistics analysis.

The supraspinal mechanism plays a key role in developing and maintaining chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, it is not clear how white matter changes in young and middle-aged males with CP/CPPS. In this cross-sectional study, 23 CP/CPPS patients and 22 healthy controls (HCs) were recruited. Tract-based spatial statistics was applied to investigate the differences in diffusion tensor imaging metrics, including fractional anisotropy (FA), mean diffusion (MD), radial diffusion (RD) and axial diffusion (AD), between CP/CPPS patients and HCs. The study also examined the association between white matter alterations and clinical variables in patients using correlation analysis. Compared with HCs, patients showed decreased FA, MD, RD and AD in the body and genu of the corpus callosum and right anterior corona radiata. In addition, they showed increased FA along with decreased MD, RD and AD in the left posterior limb of the internal capsule (PLIC-L), left external capsule and left cerebral peduncle. The FA of PLIC-L was negatively correlated with disease duration (r = -.54, corrected p =.017), while MD and RD were positively correlated (r = .45, corrected p =.042; r = .57, corrected p =.017). These results suggest that CP/CPPS is associated with extensive changes in white matter tracts, which are involved in pain processing. In particular, the FA, MD and RD values in the PLIC-L were correlated with the disease duration, indicating that the long-term course of CP/CPPS may have effects on the white matter microstructure of the pain perception pathways.

Sleep-related disorders and lower urinary tract symptoms in middle-aged and elderly males: a cross-sectional study based on NHANES 2005-2008.

Lower urinary tract symptoms (LUTS) and sleep disorders both commonly affect people's quality of life. This study aimed to explore the associations between sleep-related disorders and LUTS through epidemiological investigations. Data were generated from the cross-sectional study called theNational Health and Nutrition Examination Survey (NHANES) 2005-2008. Multivariable logistic regression models were conducted to investigate the relationships between sleep-related disorders and LUTS. A total of 2516 men were included in the study.Participants sleeping ≤ 6h/night had higher odds ratios of LUTS (OR: 1.38; 95% CI 1.08, 1.77), daytime LUTS (OR: 1.26; 95% CI 1.03, 1.54), and nocturia (OR: 1.23; 95% CI 1.02, 1.49) than those sleeping 7-8h/night. Participants who required > 30 min to fall asleep had an approximately 39% higher odds ratios of nocturia than those who fell asleep within6to30min (OR: 1.39; 95% CI 1.12, 1.73). Sleep problems were positively related to LUTS (OR: 1.42; 95% CI 1.11, 1.82), daytime LUTS (OR: 1.32; 95% CI 1.08, 1.61), urinary hesitancy (OR: 1.75; 95% CI 1.31, 2.34), and nocturia (OR: 1.52; 95% CI 1.26, 1.84). Obstructive sleep apnea (OSA) symptoms were positively associated with urinary incontinence (OR: 1.52; 95% CI 1.12, 2.08). In addition, participants with daytime sleepiness were at higher prevalence of LUTS (OR: 1.66; 95% CI 1.29, 2.15), daytime LUTS (OR: 1.44; 95% CI 1.16, 1.78), urinary hesitancy (OR: 1.95; 95% CI 1.45, 2.63), and nocturia (OR: 1.66; 95% CI 1.35, 2.05). The findings suggested that sleep-related disorders were associated with LUTS, daytime LUTS, urinary hesitancy, incomplete emptying, urinary incontinence, and nocturia in middle-aged and elderly males.

Recent Trends in Cycling Behaviour in Older Males: An Analysis and Plea for Therapeutic Options

In recent years there has been an increase in middle-aged and older males riding bicycles along city streets. While this in itself would not seem to represent a problem, a number of issues arise. Firstly, these riders do not seem to venture outdoors unless they are surrounded

Heterotaxy Syndrome In A Middle-Aged Pakistani Male

Background: Heterotaxy syndrome (or situs ambiguous) is an extremely rare disorder in which the viscera are arranged in an abnormally asymmetrical pattern around the midline along with cardiac and spleen abnormalities. The management of this disorder depends upon the extent and variability of the organ involvement and a multi-disciplinary approach is often required.&#x0D; Case presentation: A middle-aged male presented in pulmonology OPD with with complaint of hemoptysis and shortness of breath for 3 weeks. He had a history of cyanotic spells since childhood. His HRCT chest revealed dextrocardia, generalized mild centrilobular emphysema of the lungs with fibrotic bands and mild cylindrical bronchiectasis and his echocardiography showed dextrocardia along with ventricular septal defect and pulmonary hypertension. He was found to have abnormally positioned abdominal viscera along with multiple spleens and he was diagnosed as a case of heterotaxy syndrome with left isomerism. His respiratory symptoms were treated conservatively and the patient was referred to the cardiology unit for management of cardiac defects.&#x0D; Conclusion: This manuscript describes a case of heterotaxy syndrome which is a rare disorder with significant mortality and morbidity. The patient may present with vague symptoms. Early involvement of all the relevant specialities might help in a prompt diagnosis and timely management, which may improve the disease outcome.

The relationship between low handgrip strength with or without asymmetry and fall risk among middle-aged and older males in China: evidence from the China Health and Retirement Longitudinal Study.

This study sought to explore the potential correlation between low handgrip strength (HGS) with or without asymmetry and fall risk in middle-aged and older Chinese adults. Baseline characteristic data from participants 45+ years of age and data regarding fall events collected from two rounds (2011-2013) of the China Health and Retirement Longitudinal Study were utilized for the present analyses. HGS and HGS asymmetry was defined according to the updated American Society of Hand Therapist. Fall events were identified through self- or proxy-reported details. Logistic regression analyses were employed to gauge the potential relationship between abnormal HGS and fall risk. In total, 10 563 participants were enrolled in this analysis, of whom 47.49% (5016/10 563) were male. The proportions of low HGS alone, HGS asymmetry alone, and low HGS with asymmetry were 22.23%, 18.34%, and 22.75%, respectively, in males, but just 3.64%, 35.12%, and 6.62% in females. A total of 693 and 1019 fall events were recorded for male (13.82%) and female (18.37%) participants over the 2-year follow-up period, respectively. Significant differences in fall event incidence among different HGS groups were only observed among males. An adjusted logistic regression analysis model confirmed that low HGS with dominant asymmetry was closely related to fall risk among middle-aged and older males [P = 0.014, odds ratio = 1.332, 95% confidence interval: 1.059-1.676). These results demonstrated that low HGS with dominant asymmetry is a risk factor linked to increased fall risk among middle-aged and older Chinese males. What is already known on this topic Low HGS or HGS asymmetry is been reported to be linked to an increased risk of falls in middle-aged and older adults; however, little is known about the association between fall risk and low HGS and/or HGS asymmetry. Main messages The prevalence of low HGS alone and low HGS asymmetry in men was significantly higher than in women, while HGS alone asymmetry was more common in women than men. The risk factor for the increased risk of falls in Chinese middle-aged and older men is low and asymmetric HGS, rather than low or asymmetric HGS alone. Low HGS with dominant asymmetry rather than nondominant asymmetry is associated with future fall risk among middle-aged and older Chinese males. Current research questions What is the mechanism for the significant difference in the proportion of abnormal HGS components between the sexes? If female subjects with low HGS and asymmetric HGS were added, would an association be observed between low HGS and asymmetric HGS falls? Is there an association between the severity of asymmetric HGS with weakness and falls?

A Study on Clinicodemographic Pattern On Infertility ¬Of Male Partner Of Infertile Couple Attending For Infertility Treatment, Sylhet, Bangladesh

Background: Male infertility is influenced by the environment, occupation, socioeconomic condition, and lifestyle. Objective: The purpose of the present study was to see the demographic profiles and clinical characteristics of an infertile couple who attended at the OPD of a tertiary hospital in Sylhet city. Methodology: This prospective longitudinal study was carried out in OPD of SOMCH, from June 2004 to December 2004. All data were taken in the performed questionnaire. Male partners of the 100 infertile couples attending the above-mentioned places at Sylhet. The study population was included with the criteria of the male partners of the infertile couples who had tried unsuccessfully for at least one year. The Exclusion criteria were men who had undergone a vasectomy. Proper history including occupational, sexual, personal, as well as medical, and surgical history, was recorded on a predesigned data collection sheet. Result: In this study, the Majority (66%) of male partners of the infertile couples were between 30-40 years of age%) and almost98% of couples had primary infertility and the proportion between primary &amp; secondary infertility is highly significant, among them 45% of couples reported within 3-5 y.rs. of marriage and 80 % of couples had regular coitus (4-5 times /wk.). In this study, the majority of the male partners had the habits of. cigarette smoking 8% had the habit of alcohol intake, and most (42%) of the male partners were a businessman. Conclusion: In conclusion, there is a significant number of young middle-aged males had primary infertility which related with life style. Mugda Med Coll J. 2022; 5(2): 67-70

Novel use of structural equation modelling to examine diet and metabolic traits associated with microvascular endothelial dysfunction in middle-aged Chinese males: a cross-sectional study

BackgroundThe present study aims to use structural equation modelling (SEM) with multiple regression pathways to examine direct and indirect links from diet and metabolic traits to microvascular endothelial dysfunction (ED)...

Aortic stiffness contributes to greater pressor responses during static hand grip exercise in healthy young and middle-aged normotensive men.

Central arterial stiffness can influence exercise blood pressure (BP) by increasing the rise in arterial pressure per unit increase in aortic inflow. Whether central arterial stiffness influences the pressor response to isometric handgrip exercise (HG) and post-exercise muscle ischemia (PEMI), two common laboratory tests to study sympathetic control of BP, is unknown. We studied 46 healthy non-hypertensive males (23 young and 23 middle-aged) during HG (which increases in cardiac output [Q̇c]) and isolated metaboreflex activation PEMI (no change or decreases in Q̇c). Aortic stiffness (aortic pulse wave velocity [aPWV]; applanation tonometry via SphygmoCor) was measured during supine rest and was correlated to the pressor responses to HG and PEMI. BP (photoplethysmography) and muscle sympathetic nerve activity (MSNA) were continuously recorded at rest, during HG to fatigue (35% maximal voluntary contraction) and 2-min of PEMI. aPWV was higher in middle-aged compared to young males (7.1±0.9 vs 5.4±0.7m/s, P<0.001). Middle-aged males also exhibited greater increases in systolic pressure (∆30±11 vs 10±8mmHg) and MSNA (∆2313±2006 vs 1387±1482%/min) compared to young males during HG (both, P<0.03); with no difference in the Q̇c response (P=0.090). Responses to PEMI were not different between groups. Sympathetic transduction during these stressors (MSNA-diastolic pressure slope) was not different between groups (P>0.341). Middle-aged males displayed a greater increase in SBP per unit change of Q̇c during HG (∆SBP/∆Q̇c; 21±18 vs 6±10mmHg/L/min, P=0.004), with a strong and moderate relationship between the change in systolic (r=0.53, P<0.001) and diastolic pressure (r=0.34, P=0.023) and resting aPWV, respectively; with no correlation during PEMI. Central arterial stiffness can modulate pressor responses during stimuli associated with increases in cardiac output and sympathoexcitation in healthy males.