Several sizes of plastic cap were designed and made to fit the vertex of the penile glans. The foreskin is prepared in the usual manner, the glans capped with the specially made plastic cap and the foreskin pulled forwards over the cap. A crushing or non-crushing forceps is applied across the foreskin. The plastic cap separates the glans from the clamp, and its unwanted portion is cut with a knife without fear of injuries in the glans. We find this method to be safe even if it is used by a surgeon with limited experience.
Matched MeSH terms: Circumcision, Male/instrumentation*; Male
Scrotal tuberculosis (TB) is rare. Lack of awareness may lead to a misdiagnosis and/or delayed diagnosis of scrotal TB. Clinicians should have a high suspicion index for scrotal TB when facing a patient with a chronic scrotal lump. Since scrotal TB can be medically cured, biopsy of the scrotal lump for pathology study and/or urine polymerase chain reaction (PCR) analysis for M. tuberculosis should be performed first for rapid diagnostic purposes, and therefore unnecessary surgery may thereby be circumvented.
Matched MeSH terms: Male; Tuberculosis, Male Genital/diagnosis*
Male factor infertility which accounts for 30-50% of infertility is a major problem faced by married couples. Congenital absence of the vas deferens, though uncommon, remains the most common abnormality seen in extratesticular ductal and ejaculatory system, accounting for 1-2% of male infertility. It may be unilateral or bilateral. Association with renal abnormality has also been reported with congenital absence of vas deferens (1). The patients are asymptomatic and the congenital abnormality is usually detected when investigation for infertility is carried out. We present a case of an unusual presentation of congenital bilateral absence of vas deferens (CBAVD).
Matched MeSH terms: Infertility, Male; Male; Male Urogenital Diseases
A 13-year-old boy who had epigastric pain and pallor for 2 months and found to have an ulcerative mass in the stomach and underwent partial gastrectomy. A diagnosis of inflammatory myofibroblastic tumour (IMT) of the stomach was made on histological examination. Three years later, recurrence in the stomach, with invasion into the pancreas and hilum of the spleen was noted and was managed by wide wedge resection of the stomach, distal pancreatectomy and splenectomy. The patient has been recurrence-free for the past 2 years. Gastric IMT is an uncommon tumour in children with unpredictable prognosis.
A case of carotid body tumour is presented. Pathology, diagnostic investigations, modalities of treatment and prognosis are discussed. With greater awareness of this condition and improvement in diagnostic investigations and surgical techniques, the outlook in managing this condition should be better.
A 30 year old Malay male developed bilateral choroiditis followed by vitiligo, poliosis and canities. CT scan showed nodular thickening of the optic nerves. Characteristic abnormalities were seen in visual and brainstem auditory evoked potentials and fluorescein angiography. These findings were in keeping with the diagnosis of Vogt-Koyanagi-Harada syndrome. Treatment with dexamethasone resulted in complete recovery of vision and partial improvement in skin and hair lesions.
A term, Malay male neonate, delivered by spontaneous vertex delivery, was found to have a huge carvenous hemangioma on the anterior chest wall. He developed respiratory failure on the second day of life. Having considered the various options possible, an emergency surgical excision was carried outat the age of 57 hours. The patient recovered after a stormy post-operative period.
Sexually deviant behaviour is a fairly common phenomenon but because it is socially embarassing, a few cases come forward for consultation and treatment on a voluntary basis. Most cases are referred by the law courts. Two such cases, one of exhibitionism and the other offetishism, were referred to the University Hospital, Kuala Lumpur in 1982. Their development histories were elaborated. A third case of sexual sadism came voluntarily for help out defaulted after the initial session. A review on the current western concepts on sexual deviation is included in the text. It is concluded that although it is generally thought that neurological conditions give rise to deviant sexual behaviour, this assumption should not be arrived at hastily, as many cases of organic mental disorders do not exhibit deviant sexual
We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions.
Three indigenous Malay surgical procedures, namely circumcision by the mudim, bone-setting by the bomoh patah and cupping, are described. It is noted that complications are associated with both circumcision and bone-setting, and suggestions are made of possible health measures to cope with the situation.
Male breast cancer accounts for only 1% of cancers in men and 1% of breast cancers. Cutaneous metastases occur less than 10% of all patients with visceral malignancies and are considered a rare and late event in progression of metastatic disease. A 45-year-old man presented with a lump in the left breast which was confirmed to be infiltrating ductal carcinoma. He underwent a left mastectomy and axillary clearance followed by chemotherapy and radiotherapy to the left chest wall. However, he was non-compliant to adjuvant tamoxifen due to hot flushes. One year later, he presented with biopsy proven cutaneous metastases. Initially he had complete excision of the lesions, however, two months later more skin lesions appeared predominantly over the chest wall and back. Hormonal therapy failed to control the metastases as such he was treated with systemic chemotherapy. He is currently on third line chemotherapy.
Infertility is a worldwide reproductive health problem which affects approximately 15% of couples, with male factor infertility dominating nearly 50% of the affected population. The nature of the phenomenon is underscored by a complex array of transcriptomic, proteomic and metabolic differences which interact in unknown ways. Many causes of male factor infertility are still defined as idiopathic, and most diagnosis tends to be more descriptive rather than specific. As such, the emergence of novel transcriptomic and metabolomic studies may hold the key to more accurately diagnose and treat male factor infertility. This paper provides the most recent evidence underlying the role of transcriptomic and metabolomic analysis in the management of male infertility. A summary of the current knowledge and new discovery of noninvasive, highly sensitive and specific biomarkers which allow the expansion of this area is outlined.
Matched MeSH terms: Infertility, Male/metabolism*; Male
Male worms of Ancylostoma braziliense, A. ceylanicum, A. kusimaense, A. malayanum, A. duodenale, A. caninum, A. tubaeforme, Agriostomum vryburgi and Cyclodontostomum purvisi have the external appendages beside the anogenital aperture. These anogenital structures are morphologically similar and are assumed to be homologous among the species with three pairs of teeth or more. In hookworms with two pairs of teeth, the anogenital structures are complex. Anogenital features can be used as a taxonomic character in separating the species.
Matched MeSH terms: Genitalia, Male/anatomy & histology*; Male
To manage male infertility caused by hormonal imbalance, infections and other predicaments, multifarious treatment strategies are emerging worldwide. Contemporary treatments, such as assisted reproductive techniques, are costly with low success rates of only 10-30%; however, herbal remedies are gaining more attention as an alternative or supplementary therapeutic modality for male infertility. The beneficial effects induced by oral intake of the roots of a small evergreen shrub, Withania sominifera (Ashwagandha) on semen quality of infertile men have previously been studied. Oral intake of Ashwagandha roots has been found to inhibit lipid peroxidation, improve sperm count and motility, and regulate reproductive hormone levels. The molecular mechanisms of these effects, however, are yet to be unveiled. In this review, we will discuss the role of herbal medicines in male infertility; provide a detailed analysis of various human and animal studies involving Withania somnifera; describe a proposed direct oxidative mechanism involving mitigation of oxidative stress as well as an indirect mechanism consisting of a gamma-aminobutyric acid-like-mimetic pathway ameliorating hormonal balance through crosstalk among different endocrine glands to improve male fertility; and how Withania somnifera supplementation mitigates risk factor-induced male infertility as well as ameliorates male fertility.
Matched MeSH terms: Infertility, Male/prevention & control*; Male