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Frequency and determinants of hypogonadism and erectile dysfunction in men with newly detected type 2 diabetes
Shahjada Selim, Hafiza Lona, Shahed Imran, Mahbubur Rahman, Samira Mahjabeen, Marufa Mustari
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Introduction: Hypogonadism in males is characterized by low serum testosterone (T) levels together with clinical symptoms and is more common in diabetes mellitus (DM). Association between DM and hypogonadism has been studied in different populations but is not clearly known in Bangladeshi population. Objectives: The objective of this study was to find out the frequency and determinants of hypogonadism and erectile dysfunction (ED) in men with newly detected type 2 DM diabetes (T2DM). Materials and Methods: A cross-sectional study encompassing 1940 newly T2DM male patients (age: 42.57 ± 7.4 years; body mass index [kg/m2]: 26 ± 5.1; mean ± standard deviation) was carried out in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, to see hypogonadism. Measurement of serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulation hormone (FSH) was measured by chemiluminescent technology. Results: Among hypogonadal subjects, according to calculated Free Testosterone (cFT) and Androgen Deficiency in the Aging Male (ADAM) criteria, the frequency of hypogonadotropic hypogonadism was 80% which, on the basis of TT and ADAM criteria, was 92.5%. There was no significant difference for hypogonadism among either the hemoglobin A1c (HbA1c) categories (P = 0.23) or age groups (P = 0.9). Hypogonadal and eugonadal groups significantly differed both according to TT and ADAM (81.5% vs. 43.4%, P = 0.01) and cFT and ADAM (93.3% vs. 47.7%, P ≤ 0.001) criteria for ED. There was a significant difference between the groups for SHBG (21.7 ± 11.6 vs. 30.71 ± 22, P = 0.05) by TT and ADAM criteria. Similarly, cFT and ADAM criteria also revealed a statistically significant difference for SHBG (38.04 ± 19.90 vs. 25.28 ± 19.37 nmol/l, P = 0.03) and total cholesterol (211.40 ± 44.7 vs. 191.3 ± 32.64 mg/dl, P = 0.04). However, in both the groups, LH, follicle-stimulating hormone (FSH), HbA1c, fasting blood sugar, 2 h after 75 g glucose, triglyceride, high-density lipoprotein, and low-density lipoprotein did not differ significantly. cFT significantly correlated with age (r = ‒0.3503, P = 001) and SHBG (r = ‒0.37, P ≤ 0.01) whereas TT with SHBG (r = 0.58, P = 0.01). By multiple regression, ED and SHBG were significant predictors for hypogonadism (P = 0.01 and 0.03, respectively). Conclusion: It was concluded that a significant number of newly detected male T2DM subjects have symptoms of hypogonadism judged on the basis of TT, cFT, and ADAM scores. Poor glycemic control may affect gonadal and erectile functions. This aspect should be considered while diagnosing male subjects as T2DM.
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Advanced polyostotic fibrous dysplasia
Mohammad Hasan Iftekhar, Mohammed Rasel Khan, . Nur-A-Musabber, Hitler Biswas, Umme Azad, Md Monju Moshwan, Palash Kumar Chanda, A B M Kamrul-Hasan
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Polyostotic fibrous dysplasia is a disorder that features the replacement of multiple areas of bone with fibrous tissue, which may cause fractures and deformity. It begins in childhood and progresses onward, affecting both sexes equally. A 23-year-old male presented with recurrent fractures of all long bones and multiple vertebrae with low trauma. X-ray showed extensive multilocular cystic lesions with ground-glass diffuse refractions throughout all long bones, multiple fracture lines and dislocation of joints, scoliosis, and compression of multiple vertebrae. Severe cortical thinning is also seen in all bones. He was managed with bisphosphonate, and significant improvement was observed.
  120 6 -
The somnometabolic syndrome
Sanjay Kalra, Navneet Agrawal, Saptarshi Bhattacharya, Rakesh Sahay
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Obstructive sleep apnea (OSA) and the various components of metabolic syndrome are closely interrelated. We propose the term somnometabolic syndrome to define the condition where OSA coexists with one or more components of metabolic syndrome. Such a definition reinforces the strong association between OSA and metabolic syndrome and will urge the clinician to screen and diagnose OSA in individuals with metabolic syndrome and vice versa. It is hoped that the usage of this new term will not only address the lacunae in screening and treatment of OSA in individuals with metabolic syndrome but will also foster collaboration and research among specialties managing OSA.
  114 8 -
Parathyroid hormone predicts radial bone loss in healthy Nigerian adults
Ayotunde Oladunni Ale, Akintayo S Oguntona, Olufunke O Adeleye, Olufunmilayo O Adeleye, Taiwo O Afe, Olusola L Adeyemo
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Objective: The correlation between bone mineral density (BMD) and bone markers is well studied in postmenopausal women and elderly men. However, related literature on healthy adults is scarce. This study determined the correlation between parathyroid hormone (PTH), BMD of the left distal radius, and other biochemical markers in apparently healthy Nigerian adults. Methods: This research included 80 (28 males/52 females) healthy participants between 22 and 50 years of age (32.10 ± 5.8 years) who met the inclusion criteria. All the participants were recruited by a systematic random sampling. Interview questionnaires were used to supplement clinical data and anthropometric measures. Fasting samples were analyzed for calcium, inorganic phosphorus, 25-hydroxyvitamin D (25[OH]D), PTH, osteocalcin (OC), alkaline phosphatase, and 24-h calcium excretion. The left distal radius BMD was examined using dual-energy X-ray absorptiometry. The data were statistically analyzed, and the significance level was set at <0.05. Results: It was found that PTH was inversely correlated with left distal radius BMD/z-score (P = 0.004). It showed positive and negative trends with serum-adjusted calcium and inorganic phosphorus (P = 0.09 and P = 0.07, respectively). Neither the OC nor 24-h calcium excretion correlated with PTH (P > 0.05). The OC was inversely correlated with BMD (P = 0.003), but not with 24-h urinary calcium excretion (P > 0.05). None of the participants had osteoporosis. Regression analysis showed that PTH and OC predict radial bone density in participants (P < 0.05). Conclusion: Higher PTH levels correlate with lower left distal radius BMD in apparently healthy participants.
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A 27-year-old man with rare genetic disorder presented with morbid obesity
Mohammad Abdul Hannan, M Ahmed Selim, A A . M. Sazzadur Rahman, Alim Al Razy, Mohammad Saifuddin, Shahjada Selim, A B. M. Kamrul-Hasan
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Overweight and obesity are rapidly increasing globally, and Bardet–Biedl syndrome (BBS) is a rare genetic disorder that can cause obesity. We report a case of a 27-year-old unmarried man with morbid obesity, retinal dystrophy, polydactyly, mental retardation, hypogonadism, and poor scholastic performance diagnosed as BBS who was admitted to our care.
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