Displaying publications 1 - 20 of 95 in total

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  1. Autophagy, a critical element in the aging male reproductive disorders and prostate cancer: a therapeutic point of view
    Raee P, Tan SC, Najafi S, Zandsalimi F, Low TY, Aghamiri S, et al.
    Reprod Biol Endocrinol, 2023 Sep 26;21(1):88.
    PMID: 37749573 DOI: 10.1186/s12958-023-01134-1
    Autophagy is a highly conserved, lysosome-dependent biological mechanism involved in the degradation and recycling of cellular components. There is growing evidence that autophagy is related to male reproductive biology, particularly spermatogenic and endocrinologic processes closely associated with male sexual and reproductive health. In recent decades, problems such as decreasing sperm count, erectile dysfunction, and infertility have worsened. In addition, reproductive health is closely related to overall health and comorbidity in aging men. In this review, we will outline the role of autophagy as a new player in aging male reproductive dysfunction and prostate cancer. We first provide an overview of the mechanisms of autophagy and its role in regulating male reproductive cells. We then focus on the link between autophagy and aging-related diseases. This is followed by a discussion of therapeutic strategies targeting autophagy before we end with limitations of current studies and suggestions for future developments in the field.
    Matched MeSH terms: Erectile Dysfunction*
  2. Fulltext Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome patients with erectile dysfunction
    Daneshwar D, Nordin A
    Medicine (Baltimore), 2022 Jan 14;101(2):e28546.
    PMID: 35029213 DOI: 10.1097/MD.0000000000028546
    INTRODUCTION: In this study, the efficacy of low intensity shock wave therapy (LSWT) in improving symptoms of chronic pelvic pain syndrome (CPPS) and erectile dysfunction (ED) was investigated.

    METHODS: Men diagnosed with CPPS and ED (n = 50) were prescribed with LSWT. The LSWT was administered in 10 sessions over the course of 5 weeks at 3,000 pulses with .25 mJ/mm2 energy flow and 5 Hz frequency. Outcome parameters were measured before and after LSWT.

    RESULTS: Clinical symptoms related to CPPS and ED were measured using four validated questionnaires namely National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function (IIEF), the International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM). The effect of LSWT on each of the three domains of NIH-CPSI, namely Pain, Symptoms, and Quality of Life (QoL) were also analyzed. Uroflowmetry was measured to assess LSWT effect on urine voiding. The mean baseline CPPS symptoms on NIH-CPSI domains of pain, symptoms and QoL were 9.92 ± 5.72 (mean ± SD), 5.14 ± 14.5, and 8.02 ± 3.17, respectively. LSWT resulted in significant reduction of CPPS symptoms on all NIH-CPSI domains (Pain = .9 ± 1.37; Symptoms = .74 ± 1.03; QoL = 1.16 ± 1.78). The baseline means of CPPS symptoms on IIEF, IPSS, and SHIM were 45.42 ± 16.24, 24.68 ± 9.28, and 14.28 ± 6.02, respectively. LSWT significant improved CPPS symptoms on IIEF (49.48 ± 28.30) and IPSS (9.04 ± 7.01) but not on SHIM (16.02 ± 9.85). No statistically significant differences were observed with all uroflowmetry parameters.

    CONCLUSION: The current study demonstrated for the first time the safety and efficacy of LSWT administered in 10 sessions over 5 weeks in improving symptoms of CPPS and ED without causing any significant adverse effect to the patient.

    Matched MeSH terms: Erectile Dysfunction/complications*
  3. Erectile dysfunction management: a critical appraisal of clinical practice guidelines with the AGREE II instrument
    Hazir B, Haberal HB, Asci A, Muneer A, Gudeloglu A
    Int J Impot Res, 2021 May 03.
    PMID: 33941879 DOI: 10.1038/s41443-021-00442-7
    Our study aimed to assess the methodological strengths and weaknesses of erectile dysfunction clinical practice guidelines (CPGs) for individuals using the AGREE II tool. Erectile dysfunction related CPGs were identified from three databases: the National Guideline Clearinghouse, the Guidelines International Network, and PubMed between 2000 and 2020. We designed an independent assessment for each of the erectile dysfunction related CPGs using the AGREE II tool. Four appraisers performed these assessments. The literature search identified 8 CPGs that met our inclusion criteria. The evaluation of the AGREE II domains of each individual revealed that the median scores of domains related to applicability were quite low (39%). Also, the median scores of domains related to the rigour of development and the stakeholder involvement were relatively low (53% and 63%). We determined the highest median scores in three AGREE II domains: clarity of presentation (80.5%), editorial independence (77%), and scope and purpose (89.5%). We found that the European Association of Urology (EAU), the American Urological Association (AUA), and the British Society for Sexual Medicine (BSSM) guidelines had >60% in >4 domains and that their average AGREE II scores were over 70%. In the Canadian Diabetic Association (CDA) and the Japanese Society for Sexual Medicine (JSSM) guidelines, we found that >4 domains were >60%, but their average AGREE II scores were below 70%. The British Medical Journal (BMJ), the Canadian Urologic Association (CUA), and the Malaysian Urologic Association (MUA) guidelines had >60% in <3 domains. We highly recommended EAU, AUA and BSSM guidelines, while we moderately recommended CDA and JSSM guidelines. BMJ, CUA and MUA guidelines were weakly recommended. The quality of the guidelines for erectile dysfunction was variable according to AGREE II. We noted significant deficiencies in the methodological quality of the CPGs developed by different organisations in the areas of applicability and rigour of development.
    Matched MeSH terms: Erectile Dysfunction
  4. Fulltext Efficacy of Aspirin for Vasculogenic Erectile Dysfunction in Men: A Meta-Analysis of Randomized Control Trials
    Irfan M, Ismail SB, Noor NM, Hussain NHN
    Am J Mens Health, 2020 10 29;14(5):1557988320969082.
    PMID: 33111628 DOI: 10.1177/1557988320969082
    One of the major causes of erectile dysfunction (ED) is an endothelial vascular disorder. This meta-analysis is performed to determine the efficacy of aspirin on erectile function in men with vasculogenic ED. For this purpose, CENTRAL, MEDLINE, and reference lists of articles up to November 2019 were searched. Randomized controlled trials (RCTs) were selected that compared aspirin with placebo in men of any ethnicity with vasculogenic ED. A total of 58 trials were retrieved. Finally, two trials of 214 men fulfilled our selection criteria. High selection and detection bias were identified for one trial. The participants showed a significant improvement in erectile function when they took aspirin (mean difference: 5.14, 95% CI [3.89, 6.40], and I2 = 0%). Although the present meta-analysis suggested that aspirin has a significant effect on the improvement of erectile function, there were limited RCTs available on this topic and doses of aspirin varied. Additional studies are needed to support findings from this meta-analysis. Aspirin needs to be considered by practitioners when prescribing drugs for vasculogenic ED.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*
  5. Fulltext Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review
    Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB
    Am J Mens Health, 2020 7 7;14(4):1557988320937200.
    PMID: 32623948 DOI: 10.1177/1557988320937200
    Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia compared to Europe due to conservative cultural and religious beliefs, socioeconomic conditions, and lack of awareness. There is a tendency for the use of traditional medicines and noncompliance with and reduced access to modern healthcare. The present systematic review compared the incidence and factors of MSD in European and Asian populations. English language population/community-based original articles on MSDs published in MEDLINE from 2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50 (25 Asian and 25 European) were finally included in this review. The prevalence of erectile dysfunction (ED) (0%-95.0% vs. 0.9%-88.8%), low satisfaction (3.2%-37.6% vs. 4.1%-28.3%), and hypoactive sexual desire disorder (HSDD) (0.7%-81.4 vs. 0%-65.5%) was higher in Asian than in European men, whereas the prevalence of anorgasmia (0.4% vs. 3%-65%) was lower in Asian than in European men. Age was an independent positive factor of MSD. In European men over 60 years old, the prevalence of premature ejaculation (PE) decreased. The prevalence of MSD was higher in questionnaires than in interviews. The significant factors were age, single status, low socioeconomic status, poor general health, less physical activity, cardiovascular diseases, diabetes, obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian and European men. There is a need to conduct large studies on the various Asian populations for the effective management of MSD.
    Matched MeSH terms: Erectile Dysfunction/epidemiology*; Erectile Dysfunction/psychology
  6. Fulltext Effects of lower urinary tract symptoms (LUTS) towards men’s sexual quality of life
    Frannelya Francis, Khatijah Lim Abdullah, Jati Kasuma
    Malaysian Journal of Medicine and Health Sciences, 2020;16(105):17-0.
    MyJurnal
    Introduction: The numbers of male lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) are increasing worldwide including Malaysia. Both disorders caused significant effects on quality of life. Most men assume both disorders as age-related problem and opt to go untreated. Exploring the prevalence of both disorders and their effects on males’ quality of life in Sarawak by nurses is highly relevant. There has to be a significant change in the way these two health problems are assessed and managed by the nurses often with little or no medical participation. This study was aimed to determine the occurrence of LUTS and SD in men, and their effects on quality of life in Sarawak. Methods: A cross-sectional, survey-based study was used involving 162 male outpatients of age 40 years, recruited at outpatient clinics in Sarawak General Hospital. Questionnaires on International Prostate Symptoms Score; Danish Prostatic Symptoms Score-Sex and International Index for Erectile Function; and quality of life - Short Form-36 were given to eligible participants. Results: Results revealed that the occurrence of moderate to severe LUTS among male respondents attending non-urological clinics were14.8% and most common in 60-69 years old males. 84.6% of them experienced nocturia. 47.83% had severe erectile dysfunction and most common in 70-79 years old males. LUTS were also positively associated with erectile dysfunction. However, the findings on quality of life showed that both diseases were negatively associated with physical and mental composite summaries in Short Form-36. Con- clusions: The results implied that prevalence of both disorders and their effects on men’s quality of life is significant and have impacts on clinical practice. Contributing factors to male LUTS and SD were identified and need to be addressed accordingly to minimise the occurrence and complications of both disorders to men.
    Matched MeSH terms: Erectile Dysfunction
  7. Fulltext Angiotensin Receptor Blockers for Erectile Dysfunction in Hypertensive Men: A Brief Meta-Analysis of Randomized Control Trials
    Ismail SB, Noor NM, Hussain NHN, Sulaiman Z, Shamsudin MA, Irfan M
    Am J Mens Health, 2019 12 5;13(6):1557988319892735.
    PMID: 31795911 DOI: 10.1177/1557988319892735
    Erectile dysfunction is common in adult men, particularly those with hypertension and diabetes. The present study determines the effectiveness of angiotensin receptor blocker (ARB) drugs on erectile function in hypertensive male adults. For this purpose, CENTRAL and MEDLINE and reference lists of the articles were searched. The randomized controlled trials (RCTs) were selected that compared ARBs with conventional therapy or no treatment in men of any ethnicity who were presented with hypertension and/or diabetes. A total four trials that had 2,809 men were included. Three trials reported adequate random sequence allocation, two reported adequate blinding. Attrition bias is low in one of the included studies. All three studies are of low risk of selective reporting bias. There was an improvement in sexual activity with ARBs (valsartan) (mean difference (MD): 0.71, 95% Confidence Interval (CI) 0.66 to 0.76, I2 statistic = 0%). However, the erectile functions did not increase significantly in ARBs (losartan or telmisartan) treated men as compared to control or placebo (n = 203 vs n = 232; MD: 1.36; 95% CI: -0.97 to -3.69; I2 statistic = 80%). These results suggested that ARBs significantly improved sexual activity among hypertensive men. However, the erectile function was not significantly improved in ARBs treated men as compared to the control or placebo-treated. There were limited studies available. Hence, additional studies are needed to support findings from this review. ARBs should be considered when prescribing antihypertensive drugs to men.
    Matched MeSH terms: Erectile Dysfunction/diagnosis; Erectile Dysfunction/drug therapy*; Erectile Dysfunction/epidemiology*
  8. Fulltext Health-Seeking Behavior for Erectile Dysfunction in Methadone Maintenance Treatment Patients
    Ramli FF, Shuid AN, Pakri Mohamed RM, Tg Abu Bakar Sidik TMI, Naina Mohamed I
    Int J Environ Res Public Health, 2019 11 01;16(21).
    PMID: 31683816 DOI: 10.3390/ijerph16214249
    Background: Erectile dysfunction (ED) is commonly associated with methadone usage. However, little data is known regarding the health-seeking behavior for ED in the methadone maintenance treatment (MMT) population. This study aimed to determine the health-seeking behavior of MMT patients with ED who perceived themselves as having ED. We aimed to assess the attitudes and health-seeking behavior, the effectiveness of the treatment and the factors associated with treatment-seeking behavior. Methods: This was an observational questionnaire-based study. Patients were first screened for ED (n = 154) using the International Index of Erectile Function-5 (IIEF-5). Fifty patients with ED were evaluated for health-seeking behavior for ED. Results: More than half of the patients who thought they had ED (78%) believed their sex life was affected. Most patients (48%) did not seek any information regarding ED. Education level (p = 0.017) and marital status (p = 0.008) were predictive factors of health-seeking behavior. Conclusions: The health-seeking rate among MMT patients with ED needs to be improved. Measures to increase awareness of ED in MMT patients should be taken to overcome the barrier to health-seeking behavior. Health practitioners should take action to screen ED in this population to increase the detection rate and offer appropriate management according to the patients' needs.
    Matched MeSH terms: Erectile Dysfunction
  9. Fulltext Surgical Techniques for Correction of Penile Paraffinoma
    Salauddin SA, Ghazali H
    Malays J Med Sci, 2019 Nov;26(6):137-142.
    PMID: 31908595 MyJurnal DOI: 10.21315/mjms2019.26.6.14
    Background: Penile augmentation using injection of a foreign body into penile skin was mainly performed by non-medical personnel. Majority of these patients end up with complication of an abnormal mass formation known as penile paraffinoma.

    Methods: We described three different surgical techniques for correction of penile paraffinoma based on our single-centre experience. Informed consents were obtained from patients whose photographs were taken during the operation step.

    Results: In general, three patients had simple excision biopsy with primary suturing, four patients underwent single stage excision of circumferential granuloma with bilateral scrotal skin flap reconstruction and one patient experienced dual stage procedure. Three of them were injected with paraffin, one with silicone and the remaining four were unable to identify the substance used. All patients successfully underwent the surgical procedure and four of them had minor post-operative surgical site infection and wound gapping.

    Conclusion: All patients recovered well and the mean International Index of Erectile Function (IIEF-5) score obtained was 24.25. In our experience, excision biopsy was adequate for focal mass and reconstructive surgery using bilateral scrotal flap was suitable for circumferential mass.

    Matched MeSH terms: Erectile Dysfunction
  10. Longitudinal study on the impact of urinary continence and sexual function on health-related quality of life among Japanese men after robot-assisted radical prostatectomy
    Ngoo KS, Honda M, Kimura Y, Yumioka T, Iwamoto H, Morizane S, et al.
    Int J Med Robot, 2019 Aug;15(4):e2018.
    PMID: 31115140 DOI: 10.1002/rcs.2018
    BACKGROUND: The aim of this study is to investigate the impact of robotic-assisted radical prostatectomy (RARP) on the health-related quality of life (HRQOL).

    METHODS: We prospectively reviewed HRQOL parameters using Short-Form Health Survey, patient self-reporting of urinary incontinence and International Index of Erectile Function, among patients who underwent RARP between 2010 and 2016.

    RESULTS: Among 249 men studied, all had significantly worse HRQOL domain scores at 1 month post operatively but 24 months after surgery, all domains reached or surpassed their baseline values. Only Bodily Pain, General Health, Role-Emotional, Mental Health domains, and Mental Health Composite were significantly improved. Improvement in urinary continence was mirrored by improvements in both Mental and Physical Component Scores.

    CONCLUSIONS: Within a 2-year post-operative period, men who underwent RARP had regained their overall quality of life. The recovery of urinary continence significantly impacted the mental, physical, emotional, and social well-being of those patients.

    Matched MeSH terms: Erectile Dysfunction
  11. Fulltext Prevalence and associated factors of undiagnosed glycaemic disorders in men with erectile dysfunction attending a primary care clinic
    Ng YL, Teoh SH, Mohd Radzniwan AR, Syahnaz MH
    J Taibah Univ Med Sci, 2019 Feb;14(1):88-94.
    PMID: 31435395 DOI: 10.1016/j.jtumed.2018.12.002
    Objectives: Undiagnosed glycaemic disorders remain a major health concern as in such cases the opportunity for early interventions that can potentially prevent complications is missed. Erectile dysfunction (ED) has been suggested as a predictor for glycaemic disorders in men. However, data on men with ED having undiagnosed glycaemic disorders is limited, especially in the Malaysian context. This study aimed to identify prevalence and associated factors of undiagnosed glycaemic disorders in men with ED.
    Methods: We applied a cross-sectional purposive sampling technique on a group of 114 men with ED without underlying glycaemic disorders. They underwent a 2-h oral glucose tolerance test and the cases were then classified into two groups: normal and undiagnosed glycaemic disorders groups. The glycaemic disorders group consisted of patients with diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG). The patients were interviewed, and their medical records were reviewed for their sociodemographic and clinical profiles.
    Results: Prevalence of undiagnosed glycaemic disorders in men with ED was 41.2%. Higher age (adjusted OR = 1.10, 95% CI: 1.03, 1.17, p = 0.002) and BMI (adjusted OR = 1.16, 95% CI: 1.05, 1.29, p = 0.003) were found to be significantly associated with undiagnosed glycaemic disorders.
    Conclusion: This study found that men with ED had a high prevalence of undiagnosed glycaemic disorders. ED was associated with advancing age and higher BMI. Further research to validate the findings of this study is needed to increase the prevalence of DM screening among men with ED.
    Study site: Klinik Kesihatan Kajang, Selangor, Malaysia
    Matched MeSH terms: Erectile Dysfunction
  12. Fulltext Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia
    Nordin RB, Soni T, Kaur A, Loh KP, Miranda S
    Singapore Med J, 2019 Jan;60(1):40-47.
    PMID: 29774359 DOI: 10.11622/smedj.2018049
    INTRODUCTION: Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.

    METHODS: We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.

    RESULTS: The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).

    CONCLUSION: ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/epidemiology*
  13. Co-Morbid Erectile Dysfunction (ED) and Antidepressant Treatment in a Patient - A Management Challenge?
    Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, et al.
    Curr Drug Targets, 2019;20(2):182-191.
    PMID: 28302034 DOI: 10.2174/1389450118666170315110902
    Throughout the world, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are the commonly prescribed psychopharmacological agents for treating patients with co-morbid mental health problem and sexual dysfunction (SD). The serotonergic and noradrenergic ADs, although effective, are not without any SD adverse-effects, especially erectile dysfunction (ED). ED is a failure to obtain a satisfactory erection for rewarding sexual coitus during the phases of male's sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who were on AD. AD intervention caused remission to some of the pre- treatment psychopathology of ED. However, in many patients, AD potentially magnified the unwanted sexual sideeffects. This made the situation challenging for the mental health professional. These challenges are based on the complexity of ED, its etiology and the associated risk factors, which further add to its AD side-effect. The neuro-psychopharmacological basis for AD treatment selection was deliberated. Bio-psycho-social interventions are recommended at two pivotal stages. Firstly, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identify few modifiable risk factors for ED and associated mental health issues. Secondly, with guidance of an algorithm pathway, a practical intervention should include strategies such as dose reduction, augmentation or changing to an AD with lesser or no sexual adverse-effects. It is recommended that bupropion and mirtazepine to be prescribed when patients develop adverse sexual effects with serotonin selective reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI) and tricyclic antidepressant (TCA). Few suggestions which may be borne in mind are revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other nonpharmacological approaches which may be beneficial to both patients and their partners.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/psychology
  14. Fulltext A comparison of sexual desire in opiate-dependent men receiving methadone and buprenorphine maintenance treatment
    Yee A, Loh HS, Loh HH, Riahi S, Ng CG, Sulaiman AHB
    Ann Gen Psychiatry, 2019;18:25.
    PMID: 31649742 DOI: 10.1186/s12991-019-0249-z
    Background: Methadone is an effective therapy for opiate dependence. However, one of the commonest side effects is sexual dysfunction among male patients. Buprenorphine is an alternative to methadone. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT).

    Methods: This cross-sectional study involved 126 male opiate-dependent patient who were tested for total testosterone (TT) and prolactin levels, and were interviewed and completed the Sexual Desire Inventory-2 (SDI-2), Malay language of International Index of Erectile Function (Mal-IIEF-15) and the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) questionnaires.

    Results: There were 95 (75.4%) patients on MMT and 31 (24.6%) on BMT. Patients on MMT scored significantly lower in the sexual desire domain (Mal-IIEF-15 scores) (p 

    Matched MeSH terms: Erectile Dysfunction
  15. Fulltext Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial of Bupropion as Treatment for Methadone-Emergent Sexual Dysfunction in Men
    Yee A, Loh HS, Ong TA, Ng CG, Sulaiman AH
    Am J Mens Health, 2018 Sep;12(5):1705-1718.
    PMID: 29973132 DOI: 10.1177/1557988318784152
    Methadone is largely recognized as an effective treatment for opiate-dependent patients; however, it causes reduced brain dopaminergic action resulting in significant sexual dysfunction. Bupropion is a dopamine reuptake inhibitor which can potentially improve erectile function among male patients on methadone (MMT). This is a phase II, randomized, double-blind, parallel-group, placebo-controlled trial, involving 80 MMT male patients (73.4%) with mean age of 42.83 years ±9.68. These MMT male patients were randomly assigned into two groups to receive bupropion and placebo, respectively. The primary efficacy outcome measure was the difference between the two groups in end-point mean improvement scores using the measurement of Clinical Global Impression Scale adapted for Sexual Function (CGI-SF) at baseline (week 0) and at weeks 2, 4, and 6. Malay version of the sexual desire inventory-2 (SDI-2-BM) and Malay version of International Index of Erectile Function 15 (Mal-IIEF-15) domain scores were evaluated as secondary parameters. Improvement of the end-point mean from baseline were seen across the scores of SDI-2-BM (mean difference = 11.77 ± 2.90, 95% confidence interval (CI) [3.89, 19.54], p < .001) and Mal-IIEF-15 (mean difference = 8.37 ± 2.71, 95% CI [15.75, 0.99], p = .02), and the total plasma testosterone level (mean difference = 4.03, 95% CI [0.90, 7.15], p = .01). A categorical improvement of "much/very much improved" (CGI-SF score = 2) was reported by 58.3% ( n = 21/36) of bupropion SR-assigned versus 27.7% ( n = 10/36) placebo-assigned patient. Bupropion was well tolerated with no serious adverse events reported other than insomnia (17.7%). Six weeks of bupropion SR treatment reported significant improvement in key aspects of sexual function among male opiate-dependent patients on methadone maintenance treatment with emergent sexual dysfunction.
    Matched MeSH terms: Erectile Dysfunction/chemically induced; Erectile Dysfunction/drug therapy*
  16. Premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kelantan, Malaysia
    Ahmad Zamree MR, Shaiful Bahari I, Faridah MZ, Norhayati MN
    J Taibah Univ Med Sci, 2018 Apr;13(2):173-179.
    PMID: 31435320 DOI: 10.1016/j.jtumed.2017.10.001
    Objectives: This study aimed to determine the prevalence of premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kota Bharu, Kelantan, Malaysia.

    Methods: A cross-sectional study was conducted on 18- to 60-year-old sexually active men during at least the past 6 months. Patients with unstable psychiatric illnesses, mental retardation, and illiteracy were excluded. A questionnaire on sociodemographic factors, Malay version Premature Ejaculation Diagnostic Tool, and Malay version International Index Erectile Function-5 were distributed. Premature ejaculation was defined as a Premature Ejaculation Diagnostic Tool score of 9 and above. Descriptive analysis and simple and multiple logistic regression analyses were performed using SPSS version 22.

    Results: A total of 294 of 313 eligible men responded, with a response rate of 93.9%. The prevalence of premature ejaculation was 21.4% (n = 63). The multiple logistic regression analysis showed that mild [adj. OR (95% CI): 5.6 (1.89, 16.91); P = 0.002], mild-moderate [adj. OR (95% CI): 8.2 (2.72, 24.46); P 
    Matched MeSH terms: Erectile Dysfunction
  17. The Phosphodiasterase 5-Inhibitors (PDE-5i) for Erectile Dysfunction (ED): A Therapeutic Challenge For Psychiatrists
    Koon CS, Sidi H, Kumar J, Xi OW, Das S, Hatta MH, et al.
    Curr Drug Targets, 2018;19(12):1366-1377.
    PMID: 28215172 DOI: 10.2174/1389450118666170215164747
    Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually initiates orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in this context and constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits/ flexibilities and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED.
    Matched MeSH terms: Erectile Dysfunction/drug therapy*; Erectile Dysfunction/psychology
  18. Fulltext Premature ejaculation and quality of life among men attending Klinik Kesihatan Jaya Gading, Kuantan
    Harun Z, Ahmad S
    Int J Public Health Res, 2018;8(1):878-874.
    MyJurnal
    Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
    Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
    Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
    Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
    recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
    Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
    Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Erectile Dysfunction
  19. Fulltext UV-visible chemometrics approach for the determination of selected adulterants in claimed premixed coffee
    Muhammad Zul Fayyadh Azizo Rahman, Chong, Hui Wen, Lim, Vuanghao
    Malaysian Journal of Medicine and Health Sciences, 2018;14(102):1-6.
    MyJurnal
    Adulterated premixed coffees have turned into an issue in Malaysia lately and have caught the eye of the authorities due to death reports linked to these products. The major cause of this issue is reported that these premixed coffees have passed food inspection test and eventually released to the market for public consumption. These coffees were claimed to be spiked with several sexual enhancers like sildenafil, tadalafil, and vardenafill, which are common drugs used to treat erectile dysfunction. Methods: Chemometrics approach using UV-Vis spectroscopy was developed to detect the selected sexual enhancer drugs found in commercial coffees by employing SIMCA-P software for the multivariate statistical analysis. Seven brands of coffee samples were purchased from local stores, and 30 sachets each were tested, hence totalling to 210 samples. Each sample was named H, J, G, W, N, T, and K, respectively. Results: Three multivariate models were generated, namely principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), and partial least squares discriminant analysis (PLS-DA). OPLS-DA was selected as the best model for the overall results as it displayed minimal discriminate. Sildenafil, tadalafil, and vardenafil were detected in sample H, while vardenafil in brand J, and none in samples G, W, N, T, and K. Conclusion: OPLS-DA analysis showed discrimination for the sexual enhancer drugs in two brands of premixed coffee. The UV-Vis spectroscopy-based chemometrics method proved to be reliable and efficient in determining the selected drugs, as well as in saving time and cost.
    Matched MeSH terms: Erectile Dysfunction
  20. Fulltext Prevalence and factors associated with erectile dysfunction in male patients with human immunodeficiency virus in a teaching hospital in West Malaysia
    Enoma A, Ching SM, Hoo FK, Omar SFS
    Med J Malaysia, 2017 06;72(3):186-189.
    PMID: 28733567 MyJurnal
    INTRODUCTION: Erectile dysfunction (ED) has been associated with the treatment of human immunodeficiency virus (HIV) and chronic diseases. Sexual dysfunction data of male patients infected with HIV are still scarce in Malaysia, and ED appears to be under-reported. Therefore, this study aims to determine the prevalence and predictors of ED among male HIV patients at the University Malaya Medical Centre.

    METHODS: A cross sectional study was conducted among male HIV patients on antiretroviral therapy (ART) attending the outpatient clinic of a teaching hospital in Malaysia. A systematic random sampling method was employed in the selection of respondents. Participants were interviewed using a structured questionnaire with a 15-item international index of erectile function (IIEF-15). An appropriate statistical analysis was used to determine the associate and potential risk factors.

    RESULTS: A total of 220 males participated in this study with a mean age of 37.9±9.9; prevalence of ED among HIV patients was 82.3 % (n=180). The severity of ED was further categorized into: severe (24.1%), moderate (19.1%), mild to moderate (20.9%), and mild (18.3%). In a multivariate logistic regression analysis, patients with a lower educational background were more likely to be associated with ED (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.02-6.72; pvalue 0.046).

    CONCLUSION: This study reports that ED was prevalent among adult HIV males who are on an ART regimen. Those with a lower educational background are more likely to have ED. Hence, in managing patients with HIV, physicians should seek to identify those patients at risk of developing ED for further intervention.
    Matched MeSH terms: Erectile Dysfunction/etiology*; Erectile Dysfunction/epidemiology
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