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Insulin Resistance and Hypogonadism  [cached]
Md Ruhul Amin,Md Faruque Pathan,AHM Aktaruzzaman,Nazmul Kabir Qureshi
Delta Medical College Journal , 2013, DOI: http://dx.doi.org/10.3329/dmcj.v1i1.14968
Abstract: Backgound: The number of hypogonads is increasing day by day. It may be due to sedentary life style with increased obesity, increased tension or stressed lifestyle among all groups of populations. Visceral obesity is associated with insulin resistance, diabetes mellitus and also with hypogonadism.Objective: This study was carried out to determine the proportion of insulin resistance among male subjects with hypogonadism in different age groups along with status of erectile quality among diabetics and non diabetics.Materials and method: This cross sectional study among 161 adult male subjects aged ≥ 20 to ≤ 60 years were purposively selected from Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh between May 2009 to September 2010. Glycemic status and insulin resistance (by HOMA-R) were done and relevant history were documented.Results: The highest proportion (38.9%) of hypogonadism was in ≥ 50 years age group whereas highest proportion (39.6%) of the eugonads was in the age group of 40 to 49 years. More than half of the hypogonad subjects had weak erectile quality (54.0%) which were followed by absent erectile quality in 32.7% and 13.3% subjects had normal erectile quality. Among the eugonad subjects 41.7% had normal erectile quality, 41.6% subjects had weak erectile quality and 16.7% subjects had no erectile quality. More than ninety percent of the hypogonad subjects and about 60% of the eugonad subjects had insulin resistance. The average HOMA-R was more in the subjects with hypogonadism with diabetes which was highly significant (p-value < 0.001).Conclusion: Hypogonadism is associated with insulin resistance.
A Case Report of Idiopathic Hypogonadotropic Hypogonadism  [PDF]
Muddaiah, M,Varghese, G
Calicut Medical Journal , 2007,
Abstract: We describe a case of a 21-year-old male withabsent secondary sexual characters, and erectiledysfunction since puberty. The clue to his underlyingdisorder came with a hormonal assay, which wassuggestive of secondary hypogonadism. Futherworkup, was done to detect other causes ofhypogonadism, which was normal, hence weconcluded the patient to have Idiopathichypogonadotropic hypogonadism. This is anuncommon cause for hypogonadism and infertilityand represents one of the few treatable forms ofhypogonadism.
Folic Acid Transport to the Human Fetus Is Decreased in Pregnancies with Chronic Alcohol Exposure  [PDF]
Janine R. Hutson, Brenda Stade, Denis C. Lehotay, Christine P. Collier, Bhushan M. Kapur
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038057
Abstract: Background During pregnancy, the demand for folic acid increases since the fetus requires this nutrient for its rapid growth and cell proliferation. The placenta concentrates folic acid into the fetal circulation; as a result the fetal levels are 2 to 4 times higher than the maternal level. Animal and in vitro studies have suggested that alcohol may impair transport of folic acid across the placenta by decreasing expression of transport proteins. We aim to determine if folate transfer to the fetus is altered in human pregnancies with chronic alcohol consumption. Methodology/Principal Findings Serum folate was measured in maternal blood and umbilical cord blood at the time of delivery in pregnancies with chronic and heavy alcohol exposure (n = 23) and in non-drinking controls (n = 24). In the alcohol-exposed pairs, the fetal:maternal serum folate ratio was ≤1.0 in over half (n = 14), whereas all but one of the controls were >1.0. Mean folate in cord samples was lower in the alcohol-exposed group than in the controls (33.15±19.89 vs 45.91±20.73, p = 0.04). Conclusions/Significance Our results demonstrate that chronic and heavy alcohol use in pregnancy impairs folate transport to the fetus. Altered folate concentrations within the placenta and in the fetus may in part contribute to the deficits observed in the fetal alcohol spectrum disorders.
Incidence of sexual dysfunction: a prospective survey in Ghanaian females
Nafiu Amidu, William KBA Owiredu, Eric Woode, Otchere Addai-Mensah, Lawrence Quaye, Abass Alhassan, Edmond A Tagoe
Reproductive Biology and Endocrinology , 2010, DOI: 10.1186/1477-7827-8-106
Abstract: The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was administered to 400 healthy women between 18 and 58 years old (mean +/- SD: 30.1 +/- 7.9) domiciled in the Kumasi metropolis.The response rate was 75.3% after 99 were excluded. Of the remaining 301 women, 50% were engaged in exercise, 26.7% indulge in alcoholic beverages and only 2% were smokers. A total of 62.1% of the women had attained high education, whilst, 28.9% were married. After logistic regression analysis, alcohol emerged (OR: 2.0; CI: 1.0 - 3.8; p = 0.04) as the main risk factor for SD. The overall prevalence of SD in these subjects was 72.8%. Severe difficulties with sexual function were identified in 3.3% of the studied population. The most prevalent areas of difficulty were anorgasmia (72.4%), sexual infrequency (71.4%), dissatisfaction (77.7%), vaginismus (68.1%), avoidance of sexual intercourse (62.5%), non-sensuality (61.5%) and non-communication (54.2%). Whereas 8% had severe difficulties with anorgasmia, only 6% had severe difficulties with vaginismus.SD affects more than 70% of Ghanaian women who are sexually active. Alcohol significantly influences sexual activity.Human sexuality is a complex process which is coordinated by the neurologic, vascular and endocrine systems [1]. Sexuality does not only include family, societal and religious beliefs, it can also be influenced by aging, health status and personal experience as well as socio-economic status. Sexual dysfunction (SD) is an important public health problem that is more prevalent in women than in men [2]. Previous studies have established that up to about 76% of women experience some form of SD - that is, a sexual problem that they find distressing [3].The study and knowledge of SD has been largely unexplored and its incidence is said to vary widely possibly due to differences in criteria for defining SD: the population involved, cultural background, socio-economic level, quality of psychosexual relationships and income. An imp
An unusual cause of adult onset cerebellar ataxia with hypogonadism  [cached]
Menon Ramshekhar,Sanghani Nirav,Javali Mahendra,Jain Neeraj
Annals of Indian Academy of Neurology , 2009,
Abstract: We report an unusual case of sporadic adult onset cerebellar ataxia with hypogonadism. A 40-year-old unmarried man presented with progressive ataxia and dysarthria along with complaints of non-development of secondary sexual characteristics and erectile dysfunction. There were complaints of intermittent diarrhea. Clinical examination revealed a pan-cerebellar syndrome with features of hypoandrogenism. No eye movement abnormalities were evident. There were signs of malabsorption. Investigations confirmed the presence of auto-antibodies found in celiac disease, and a duodenal biopsy confirmed the same. Hypoandrogenism was postulated to be due to hypergonadotropic hypogonadism which has been mentioned in a few patients of celiac disease. However, the pattern seen in our patient was of a hypogonadotropic hypogonadism. This is probably secondary to an autoimmune hypophysitis seen in some patients in the absence of other clinical manifestations. Autoantibody testing should be a diagnostic necessity in any adult with a sporadic cerebellar ataxia.
Topical Testosterone Gel for the Treatment of Male Hypogonadism
Dioma U. Udeoji, Anita Phan, Peter Katsiyiannis, Robert Willix and Ernst R. Schwarz
Clinical Medicine Insights: Therapeutics , 2012, DOI: 10.4137/CMT.S7348
Abstract: Objective: This review describes the current knowledge of biological external testosterone (T) application using dermal products for the treatment of late-onset male hypogonadism (LOH). Methods: An English language search of medical literature using Pubmed was conducted between January of 1984 and March of 2012 using the search term 'testosterone gel'. Special emphasis was given to clinical controlled trials and large case studies. Results: We describe the current knowledge on testosterone replacement therapy using gel applications. A reference search revealed 1567 publications; 44 were clinical studies in human patients with male hypogonadism, 80 were reviews, 27 were case reports, and 9 were retrospective studies. Data from the literature and from 20 clinical studies involving human patients were analyzed since they met the inclusion criteria of testosterone gel administration in hypogonadal males. For the purpose of this review, a total number of 2,378 human patients were studied. Overall, biological T administration resulted in improvement of sexual dysfunction and symptoms of metabolic syndrome and represented an effective and safe treatment option for hypogonadal men. Conclusions: Administration of biological T gel appears to represent a valid alternative treatment option for male hypogonadism with a favorite efficacy and safety profile.
Decreased whole blood TNFα production capacity after acute alcohol exposure and LPS stimulation ex vivo
A Gavala, K Venetsanou, C Kittas, E Manolis, A Yiambides, P Myrianthefs, G Baltopoulos
Critical Care , 2010, DOI: 10.1186/cc8245
Abstract: Whole blood was taken from healthy volunteers and was placed in tubes containing EDTA and immediately transferred to the lab. Heparinized blood samples diluted 1:10 in RPMI 1640 culture medium (100 μl whole blood added in 900 μl RPMI 1640). Samples were pre-incubated with 0, 5, 12.5, 25, 50, 100 and 200 mM alcohol (EtOH) for 10 minutes at room temperature. After incubation, 500 pg LPS was added in each sample for 4 hours at 37°C. At the end of the process, samples were centrifuged (1,800 rpm, 5 minutes, r.t.). Culture supernatants were collected and stored at -70°C until measurements. TNFα levels were determined in culture supernatant with ELISA [2].We studied 17 healthy males volunteers aged 36.9 ± 1.6 (X ± SEM). TNFα levels are shown in Figure 1. There was no TNFα production detected in samples without alcohol in the absence of LPS stimulation (control). TNFα production was significantly decreased at a dose of alcohol of 50 mM after LPS stimulation (P < 0.05) but more apparently at doses of 100 and 200 mM alcohol (P < 0.001) compared with LPS-induced samples.Alcohol is related to inhibition of TNFα production of whole blood stimulated with LPS ex vivo [3]. This effect occurred shortly after alcohol exposure. Our observation indicates a suppression of proinflammatory response during acute alcoholic intoxication which may be related to increased susceptibility to infections.
Golden Research Thoughts , 2013, DOI: 10.9780/22315063
Abstract: In this study an attempt has been made to study stress tolerance amongdiabetics and non diabetics.. Stress Tolerance scale has been used to measure their stresstolerance. This tool was administered to 160 diabetics and 160 non diabetics fromPathanamthitta district in Kerala. The sample mainly consisted of working people. Theresult of the analysis reveals that stress tolerance seems to have a significant effect onnon diabetics compared to diabetics.
Avolition in a patient with hypogonadism
Verhoeven,Willem; Tuinier,Siegfried; Egger,Jos; van Erp,Femke; Tuerlings,Joep;
The European Journal of Psychiatry , 2008, DOI: 10.4321/S0213-61632008000400002
Abstract: background and objectives: testosterone deficiency has been implicated in the etiology of depression although there is an ongoing debate on the nature of this association. there is a paucity of data about the psychological impact of hypogonadism in genetic disorders associated with testosterone deficiency. methods: a 57-year-old male is described who was referred for treatment resistant depression. his history showed infertility and lowered testosterone. a selective literature review is given to clarify the patient's clinical condition. results: cytogenetic analysis demonstrated a robertsonian translocation between chromosomes 13 and 14 that accounted for his infertility. the psychopathological picture did not meet the criteria for a major depressive disorder but was characterized by symptoms of apathy or avolition. these symptoms were most probably aggravated by previous long lasting treatment with antidepressants. conclusions: testosterone deficiency may be related to motivational deficits that should not be misunderstood for depressive illness. apathy is probably an underestimated side effect of antidepressants.
Testosterone replacement in male hypogonadism
Sanjay Kalra, Navneet Agrawal, Satish Kumar, et al
Clinical Pharmacology: Advances and Applications , 2010, DOI: http://dx.doi.org/10.2147/CPAA.S11940
Abstract: tosterone replacement in male hypogonadism Review (4732) Total Article Views Authors: Sanjay Kalra, Navneet Agrawal, Satish Kumar, et al Published Date September 2010 Volume 2010:2 Pages 149 - 153 DOI: http://dx.doi.org/10.2147/CPAA.S11940 Sanjay Kalra1, Navneet Agrawal2, Satish Kumar3, Amit Sharma1 1Department of Endocrinology, Bharti Hospital, Karnal, India; 2Dept of Medicine, GR Medical College, Gwalior, India; 3Clinical Research, EXCEL Life Sciences, NOIDA, India Abstract: This article contains a review of the clinical aspects of testosterone replacement in androgen deficiency of the aging male.
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