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Esquivel-Zuniga R, Rogol AD. Functional hypogonadism in adolescence: an overlooked cause of secondary hypogonadism. Endocr Connect 2023; 12:e230190. [PMID: 37615381 PMCID: PMC10563622 DOI: 10.1530/ec-23-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/24/2023] [Indexed: 08/25/2023]
Abstract
Hypogonadism is a clinical syndrome resulting from failure to produce physiological concentrations of sex steroid hormones with accompanying symptoms, such as slowed growth and delayed pubertal maturation. Hypogonadism may arise from gonadal disease (primary hypogonadism), dysfunction of the hypothalamic-pituitary axis (secondary hypogonadism) or functional hypogonadism. Disrupted puberty (delayed or absent) leading to hypogonadism can have a significant impact on both the physical and psychosocial well-being of adolescents with lasting effects. The diagnosis of hypogonadism in teenagers can be challenging as the most common cause of delayed puberty in both sexes is self-limited, also known as constitutional delay of growth and puberty (CDGP). Although an underlying congenital cause should always be considered in a teenager with hypogonadism, acquired conditions such as obesity, diabetes mellitus, other chronic diseases and medications have all been associated with low sex steroid hormone levels. In this review, we highlight some forms of functional hypogonadism in adolescents and the clinical challenges to differentiate normal variants from pathological states.
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Affiliation(s)
| | - Alan D Rogol
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
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Ata F, Rahhal A, Malkawi L, Iqbal P, Khamees I, Alhiyari M, Yousaf Z, Qasim H, Alshurafa A, Sardar S, Javed S, Fernyhough L, Yassin M. Genotypic and Phenotypic Composition of Sickle Cell Disease in the Arab Population - A Systematic Review. Pharmgenomics Pers Med 2023; 16:133-144. [PMID: 36851992 PMCID: PMC9961577 DOI: 10.2147/pgpm.s391394] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
Sickle cell disease (SCD) is a genetic disease influenced by ethnicity and regional differences in its clinical course. Recent advances in the management of SCD with newer therapies are being introduced to the Western population. However, many of these treatments are yet to be used in the Arabic SCD population. Understanding the genetic variations of SCD regionally is essential to anticipate the utilization of new treatments. This systematic review's main objective is to pool the available data on the genetic composition of SCD in the Arabic population. Data for 44,034 patients was extracted from 184 studies (11 case reports, 8 case series, 56 retrospectives, 107 prospective observational studies, and 2 clinical trials) using PubMed, Scopus, and Google Scholar. Male (49%) and female (51%) patients were equally reported wherever gender was available (N=13105). Various SCD genotypes were reported in a total of 14,257 patients, including Hb SS (77%) Hb Sβ0 (9.9%), and Hb Sβ+ (7.2%), while the rest of the genotypes, including HbSC, HbSD, HbSE, HbSO Arab, Hb S/α-Thal, Hb Sβ0 + α-Thal, and HBS Oman were individually reported in <4% of the cases. Major SCD complications in the Arab population included pain crises (48.25%) followed by neurological complications (33.46%), hepatobiliary complications (25.53%), musculoskeletal complications (24.73%), and hemolytic anemia (23.57%). The treatments reported for SCD included hydroxyurea (20%), blood transfusion (14.32%), and Deferasirox (3.03%). We did not find the use of stem cell transplantation or newer treatments such as L-Glutamine, Voxelotor, Crizanlizumab, or gene therapy reported in any of the studies included in our review. This review highlights the genetic makeup of SCD in Arab countries and its common phenotypic manifestations and will help direct further research on SCD in this region, especially concerning genetic therapy. Systematic Review Registration The protocol has been registered in the International Prospective Register of Systematic Reviews(PROSPERO):CRD42020218,666. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=218666.
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Affiliation(s)
- Fateen Ata
- Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alaa Rahhal
- Department of Clinical Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | - Lujain Malkawi
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Phool Iqbal
- Department of Internal Medicine, Metropolitan Hospital, New York, NY, USA
| | - Ibrahim Khamees
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mousa Alhiyari
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Zohaib Yousaf
- Department of Internal Medicine, Reading Hospital - Tower Health, West Reading, PA, USA
| | - Hana Qasim
- Department of Internal Medicine, UMKC School of medicine, Kansas, MO, USA
| | - Awni Alshurafa
- Department of Medical Oncology /Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Sundus Sardar
- Department of Medicine, Division of Nephrology, Pennsylvania State University College of Medicine, Hershey Medical Center, Hershey, PA, USA
| | - Saad Javed
- Department of Internal Medicine, Icahn school of medicine at Mount Sinai/Queens Hospital Center, New York, NY, USA
| | - Liam Fernyhough
- Department of Medical Oncology /Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.,Department of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Mohamed Yassin
- Department of Medical Oncology /Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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Delgouffe E, Braye A, Goossens E. Testicular Tissue Banking for Fertility Preservation in Young Boys: Which Patients Should Be Included? Front Endocrinol (Lausanne) 2022; 13:854186. [PMID: 35360062 PMCID: PMC8960265 DOI: 10.3389/fendo.2022.854186] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022] Open
Abstract
Due to the growing number of young patients at risk of germ cell loss, there is a need to preserve spermatogonial stem cells for patients who are not able to bank spermatozoa. Worldwide, more and more clinics are implementing testicular tissue (TT) banking programs, making it a novel, yet indispensable, discipline in the field of fertility preservation. Previously, TT cryopreservation was predominantly offered to young cancer patients before starting gonadotoxic chemo- or radiotherapy. Nowadays, most centers also bank TT from patients with non-malignant conditions who need gonadotoxic conditioning therapy prior to hematopoietic stem cell (HSCT) or bone marrow transplantation (BMT). Additionally, some centers include patients who suffer from genetic or developmental disorders associated with prepubertal germ cell loss or patients who already had a previous round of chemo- or radiotherapy. It is important to note that the surgical removal of TT is an invasive procedure. Moreover, TT cryopreservation is still considered experimental as restoration methods are not yet clinically available. For this reason, TT banking should preferably only be offered to patients who are at significant risk of becoming infertile. In our view, TT cryopreservation is recommended for young cancer patients in need of high-risk chemo- and/or radiotherapy, regardless of previous low-risk treatment. Likewise, TT banking is advised for patients with non-malignant disorders such as sickle cell disease, beta-thalassemia, and bone marrow failure, who need high-risk conditioning therapy before HSCT/BMT. TT retrieval during orchidopexy is also proposed for patients with bilateral cryptorchidism. Since patients with a medium- to low-risk treatment generally maintain their fertility, TT banking is not advised for this group. Also for Klinefelter patients, TT banking is not recommended as it does not give better outcomes than a testicular sperm extraction later in life.
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Akhter MS, Hamali HA, Iqbal J, Mobarki AA, Rashid H, Dobie G, Madkhali AM, Arishi BYH, Ageeli EOO, Laghbi OSH. Iron Deficiency Anemia as a Factor in Male Infertility: Awareness in Health College Students in the Jazan Region of Saudi Arabia. Int J Environ Res Public Health 2021; 18:ijerph182412866. [PMID: 34948476 PMCID: PMC8701172 DOI: 10.3390/ijerph182412866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
Male contribution towards couple infertility is increasing but is less discussed. We aimed to assess the knowledge about iron deficiency anemia (IDA) as a contributor to male infertility in students at health colleges of Jazan University. A multicentric, cross-sectional survey included 910 participants and 768 participants qualified as per our inclusion criteria. The questions were categorized as: Model 1—knowledge about IDA-induced male infertility; Model 2—knowledge about IDA. The average knowledge of IDA causing male infertility is very low among students. The 18–20 years age group had a lesser score for either knowledge of IDA (M2; p-value = 0.047) or total (p-value < 0.0001) compared to the older group. In addition, female students were significantly more likely to be better in achieving higher total scores (p-value = 0.023) as well as M2 scores (p-value < 0.0001) when compared to the respective male category. On the other hand, males were significantly better in scoring for M1 (p-value = 0.004) compared to females. Awareness about iron deficiency anemia as a factor in male infertility may reduce the infertility burden, arising from a preventable factor, in the Jazan region.
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Affiliation(s)
- Mohammad S. Akhter
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
- Correspondence:
| | - Hassan A. Hamali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Johar Iqbal
- Department of Biochemistry, College of Medicine, Jazan University, Jizan 45142, Saudi Arabia;
| | - Abdullah A. Mobarki
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Hina Rashid
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jizan 45142, Saudi Arabia;
| | - Gasim Dobie
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Aymen M. Madkhali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Bader Y. H Arishi
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Emad O. O. Ageeli
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
| | - Osama S. H. Laghbi
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia; (H.A.H.); (A.A.M.); (G.D.); (A.M.M.); (B.Y.H.A.); (E.O.O.A.); (O.S.H.L.)
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Okar L, Rezek M, Abdelhamid MT, Yassin MA. Case report of active pulmonary TB in a sickle cell disease patient. Ann Med Surg (Lond) 2021; 72:103073. [PMID: 34840778 PMCID: PMC8605379 DOI: 10.1016/j.amsu.2021.103073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022] Open
Abstract
Both Sickle cell disease (SCD) and Tuberculosis (TB) are prevalent, and mostly concentrated in similar geographic areas. Since there is an overlap of the possible presenting symptoms of SCD complications and TB, a low threshold for suspicion of TB in these patients is recommended. We present a case of an active TB infection in a SCD patient that presented mainly with chronic cough. SCD and TB has similar geographic pattern in prevalence. Physician should distinguish between acute chest syndorme that happens among SCD patients and the presentation of active TB either clinical or radiographically. Raising the clinical submission of TB infection in patients with SCD presenting with chronic cough only.
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Affiliation(s)
- Lina Okar
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Rezek
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | | | - Mohamed A Yassin
- Department of Medical Oncology, Hematology Section, National Center for Cancer Care & Research, Hamad Medical Corporation, Doha, Qatar
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