1.Antimicrobial Management of Complicated Skin and Soft Tissue Infections in an Era of Emerging Multi-Drug Resistance: Perspectives from 5 Gulf Countries
Wadha ALFOUZAN ; Zainab AL-BALUSHI ; Muna AL-MASLAMANI ; Asmaa AL-RASHED ; Salman AL-SABAH ; Jameela AL-SALMAN ; Mohamed BAGUNEID ; Faryal KHAMIS ; Nervana HABASHY ; Ayman KURDI ; Christian ECKMANN
Journal of Acute Care Surgery 2021;11(3):89-101
The number of complicated skin and soft tissue infections (cSSTIs) in the Arabian Gulf region has risen in recent years, particularly those caused by multi-drug resistant (MDR) pathogens. The high prevalence of diabetes, obesity, and associated cardio-metabolic comorbidities in the region renders medical and surgical management of cSSTI patients with MDR infections challenging. An experienced panel of international and regional cSSTI experts (consensus group on cSSTIs) was convened to discuss clinical considerations for MDR infections from societal, antimicrobial stewardship, and cost perspectives, to develop best practice recommendations. This article discusses antibiotic therapies suitable for treating MDR cSSTIs in patients from the Gulf region and recommends that these should be tailored according to the local bacterial ecology by country and region. The article highlights the need for a comprehensive patient treatment pathway and defined roles of each of the multidisciplinary teams involved with managing patients with MDR cSSTIs. Aligned and inclusive definitions of cSSTIs for clinical and research purposes, thorough and updated epidemiological data on cSSTIs and methicillin-resistant Staphylococcus aureus in the region, clearcut indications of novel agents and comprehensive assessment of comparative data should be factored into decision-making are necessary.
2.Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele:A Systematic Review and Meta-Analysis
Rossella CANNARELLA ; Rupin SHAH ; Ramadan SALEH ; Florence BOITRELLE ; Taha Abo-Almagd Abdel-Meguid HAMODA ; Rajender SINGH ; Gianmaria SALVIO ; Tuncay TOPRAK ; Marco FALCONE ; Murat GUL ; Fotios DIMITRIADIS ; Amarnath RAMBHATLA ; Giorgio I. RUSSO ; Edmund KO ; Armand ZINI ; Parviz KAVOUSSI ; Nguyen Ho Vinh PHUOC ; Hussein KANDIL ; Ramy Abou GHAYDA ; Ponco BIROWO ; Nazim GHERABI ; Erman CEYHAN ; Jie DONG ; Vineet MALHOTRA ; Damayanthi DURAIRAJANAYAGAM ; Bircan KOLBASI ; Fahmi BAHAR ; Gokhan CALIK ; Selahittin ÇAYAN ; Germar-Michael PINGGERA ; Aldo E. CALOGERO ; Osvaldo RAJMIL ; Taymour MOSTAFA ; Widi ATMOKO ; Ahmed M. HARRAZ ; Tan V. LE ; Jean de la ROSETTE ; Lukman HAKIM ; Edoardo PESCATORI ; Oleg SERGEYEV ; Ayman RASHED ; Pallavi SAINI ; Ashok AGARWAL
The World Journal of Men's Health 2024;42(2):321-337
Purpose:
Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA).
Materials and Methods:
A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD).
Results:
Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD −1.125, 95% confidence interval [CI] −1.410, −0.840; p<0.0001) with high inter-study heterogeneity (I2=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD −1.014, 95% CI −1.263, −0.765; p<0.0001, and SMD −1.495, 95% CI −2.116, −0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD −2.197, 95% CI −3.187, −1.207; p<0.0001), sperm chromatin structure assay (SMD −0.857, 95% CI −1.156, −0.559; p<0.0001) or TUNEL (SMD −1.599, 95% CI −2.478, −0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD −2.450, 95% CI −3.903 to −0.997, p=0.001) with high inter-study heterogeneity (I2=93.7%).
Conclusions
Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.
3.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
4.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
5.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
6.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
7.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.