Control and treatment of type 2 diabetes in private patients in the Egyptian "DIACONTROL study".

OBJECTIVE: This study aims to identify the characteristics of Egyptian patients suffering from type 2 diabetes mellitus (T2DM), determine disease control rates, and gain insights into clinical treatments. PATIENTS AND METHODS: A total of 2,516 patients with T2DM were recruited from 244 private clinics across Egypt in a one-month period from May to June 2017. Data collected from patients included glycemic control parameters of glycosylated hemoglobin, fasting plasma glucose, and postprandial glucose. Additional information gathered included patients' weight, age, level of physical activity, smoking habits, presence of comorbidities, type of treatment received for type 2 diabetes, number and severity of hypoglycemic events, as well as treatment modification by the physician in the last visit. The type of statistics used for the analysis is descriptive statistics and regression model. RESULTS: Only 18.4% of participating patients achieved the target level of glycosylated hemoglobin of 7% or below. The mean age of these patients was 54±11.2 years, and the mean duration since the first diagnosis was 6.6±6.4 years. A total of 33.4% of all patients had no known comorbidity, while the rest had one or more known and treated comorbidities. A total of 76% of patients received sulfonylurea either as monotherapy or in combination with other treatments. In addition, no treatment modifications or adjustments were provided for 32% of the study participants who did not reach their glycemic control target. CONCLUSIONS: In Egypt, there is a low rate of glycemic control among private patients and a high prevalence of comorbid conditions. This is likely to cause a significant health burden to people with T2DM, the healthcare system, and the economy due to a loss in productivity. This study presented an argument for better-managed measures to improve glycemic control in the population, such as patient education to increase patient awareness and adherence to treatment protocols as well as improved adherence to guidelines by clinicians.

Glucose-6-phosphate dehydrogenase deficiency enhances Covid-19 infection in elderly people.

Our understanding of the mechanisms responsible for death of aged people from Covid-19 became one of the major concerns of these days. Glucose-6-phosphate dehydrogenase (G6PD) enhances the normal senescence and accelerates the precocious removal of chronologically young, yet biologically aged cells. Thus, its deficiency is associated with an increase in the cellular oxidative stress. Accumulating evidence showed that oxidative stress has a fundamental role in several age-related diseases. Nowadays, Covid-19 is considered a serious health problem worldwide. The host cellular environment is the key determinant of pathogen Infectivity. Most respiratory viral infections have a strong association with Glucose-6-phosphate dehydrogenase. Unfortunately, this enzyme deficiency markedly decreases with aging what is involved in increasing of the morbidity rate. The aim of this mini review was to shed more light on the role of G6PD deficiency in aged people infected with Covid-19 (Ref. 20). Keywords: GSPD, Covid-19, elderly people.

Association of ficolin-2 gene polymorphisms and susceptibility to systemic lupus erythematosus in Egyptian children and adolescents: a multicenter study.

BACKGROUND: Pediatric-onset SLE (pSLE) is a multisystem autoimmune disease. Recently, the ficolin-2 (FCN2) gene has emerged as a potential candidate gene for susceptibility to SLE. OBJECTIVES: The objective of this study was to evaluate the association of the FCN2 gene polymorphisms at positions -986 (G/A), -602 (G/A), -4 (A/G) and SNP C/T (rs3124954) located in intron 1, with susceptibility to pSLE in Egyptian children and adolescents. METHODS: This was a multicenter study of 280 patients diagnosed with pSLE, and 280 well-matched healthy controls. The FCN2 promoter polymorphisms at -986 G/A (rs3124952), -602 G/A (rs3124953), -4 A/G (rs17514136) and SNP C/T (rs3124954) located in intron 1 were genotyped by polymerase chain reaction, while serum ficolin-2 levels were assessed using enzyme-linked immunosorbent assay. RESULTS: The frequencies of the FCN2 GG genotype and G allele at -986 and -602 positions were significantly more represented in patients with pSLE than in controls (p < 0.001). Conversely, the FCN2 AA genotype and A allele at position -4 were more common in patients than in controls (p < 0.001). Moreover, patients carrying the FCN2 GG genotype in -986 position were more likely to develop lupus nephritis (odds ratio: 2.6 (95% confidence interval: 1.4-4.78); p = 0.006). The FCN2 AA genotype at position -4 was also identified as a possible risk factor for lupus nephritis (odds ratio: 3.12 (95% confidence interval: 1.25-7.84); p = 0.024). CONCLUSION: The FCN2 promoter polymorphisms may contribute to susceptibility to pSLE in Egyptian children and adolescents. Moreover, the FCN2 GG genotype at position -986 and AA genotype at position -4 were associated with low serum ficolin-2 levels and may constitute risk factors for lupus nephritis in pSLE.

Mechanism of grape seeds extract protection against paracetamol renal cortical damage in male Albino rats.

OBJECTIVE: The aim of the study was to assess the possible protective role of grape seeds extract (GSE) in ameliorating the toxic effects of paracetamol overdose on the rat renal cortical tissue. BACKGROUND: Paracetamol is one of the widely used non-steroidal anti-inflammatory drugs (NSAIDs). Unfortunately, it was reported as the most common cause of toxic ingestion in the world. Grape seeds extract (GSE) is known to have a strong antioxidant and anti-inflammatory properties. METHODS: The rats were divided into 4 groups; control group, GSE group, paracetamol group and GSE with paracetamol group. Kidney specimens were processed for biochemical, histological and immunohisto-chemical studies. RESULTS: The study showed marked biological changes in the form of significant increase in serum urea and creatinine levels with significant decrease in renal superoxide dismutase with paracetamol group. Furthermore, Proximal (PCT) and distal convoluted tubules showed marked degeneration, dense nuclear staining, cytoplasmic vacuolization, and partial loss of the brush borders. Most tubules were dilated, irregular and were filled with hyaline casts. PCT and DCT showed less PAS reaction and more COX-2 and caspase expression if compared with the control and the GSE groups. Concomitant administration of grape seeds extract with paracetamol revealed a noticeable amelioration of these biochemical and histological changes. Proximal and distal convoluted tubules showed less PAS reaction and more COX2 and caspase expression if compared with the control and the GSE. Concomitant administration of GSE with paracetamol revealed a noticeable amelioration of these biochemical and histological changes. CONCLUSION: Grape seeds extract provided biochemical and histo-pathological improvement in paracetamol induced renal cortical toxicity. These findings revealed that this improvement was associated with a decrease in oxidative damage and apoptosis (Tab. 1, Fig. 7, Ref. 55).

Comparative Placental Anatomy: Divergent Structures Serving a Common Purpose.

The placenta, one of the most important transient organs, forms by the apposition of fetal membranes and maternal tissues. Its role is to mediate physiological exchanges between mother and fetus. The word "apposition" covers a wide range of structural variations. It includes approximation, adhesion, interdigitation, or actual fusion between fetal and maternal tissues.1 Formation of the placenta establishes hemotropic nutrition for the fetus: essential metabolites must be provided to maintain the growing fetus, and these must come to it via the maternal circulatory system.2,3 Equally important, the placenta also provides oxygen and removes metabolic waste products from fetal blood. Nutritive and excretory roles of the placenta are not its only functions: it also has immune and endocrine activities.4 Nutrient and gas transport, waste removal, immunological protection of the fetus, and hormonal secretion influencing the maternal metabolism are all complex functions. They may also to some extent be conflicting purposes; hence, the placenta is a complex fetal organ. It is structurally adapted to perform its roles somewhat differently in different species, but the set of functions remain the same. Understandably, the placenta has been the subject of extensive research, and it will continue be an important topic thanks to its complexity. The intent of this chapter is to provide a simple description of placental anatomy using classic categories and to describe anatomical species variations in humans, important domestic animals, and the major laboratory species.

SYNTHESIS, REACTIONS, AND BIOLOGICAL ACTIVITY OF SOME TRIAZINE DERIVATIVES CONTAINING SULFA DRUG MOIETIES.

Thienyl-triazine-sulphonamide conjugates were prepared from their precursor amines using triethyl orthoformate or ethyl chloroformate as cross coupling reagents. The progress of these reactions was investigated by spectral (IR, NMR, MS) and microanalytical techniques. The synthesized compounds were in vitro screened for antibacterial, antifungal, antioxidant, and anticancer activity. 4-[({[3-Mercapto-5-oxo-6-[2-(2-thienyl)yinyl]-1,2,4-triazin- 4(5H)-yl]imino}methyl)amino]-benzenesulfonamide turned out to be a powerful antibacterial agent, while all the compounds prepared were inactive against fungal species tested. 4-{[({8-Cyano-4-oxo-3-[2-(2-thienyl)vinyl- 4H,8H-[1,2,4]triazino[3,4-b][1,3,4]thiadiazin-7-yl}amino)(ethoxy)methyl]amino}benzenesulfonamide displayed in vitro promising cytotoxicity against Ehrlich ascites carcinoma cell line with concurrent attenuation of malonodinitrile and it was unique among other compounds being unable to increase glutathione S-transferase and reduced glutathione S-transferase activities. This compound exhibited also good antioxidant properties that together with its cytotoxicity nominated it for further investigation in cancer research.

Determinants of hand hygiene compliance in Egypt: building blocks for a communication strategy.

Hand hygiene of health-care staff is one of the most important interventions in reducing transmission of nosocomial infections. This qualitative study aimed to understand the behavioural determinants of hand hygiene in order to develop sustainable interventions to promote hand hygiene in hospitals. Fourteen focus group discussions were conducted with nurses in 2 university hospitals in Egypt. The interviews were tape recorded and transcribed. Thematic analysis was conducted by 2 independent investigators. The findings highlighted that nurses did not perceive the benefits of hand hygiene, and that they linked the need to wash hands to a sense of dirtiness. Knowledge of hand hygiene and related products was limited and preference for water and soap was obvious. Environmental constraints, lack of role models and social control were identified as barriers for compliance with hand hygiene. A multi-faceted hand hygiene strategy was developed based on existing cultural concepts valued by the hospital staff.

Determinants of hand hygiene compliance in Egypt: building blocks for a communication strategy

Hand hygiene of health-care staff is one of the most important interventions in reducing transmission of nosocomial infections. This qualitative study aimed to understand the behavioural determinants of hand hygiene in order to develop sustainable interventions to promote hand hygiene in hospitals. Fourteen focus group discussions were conducted with nurses in 2 university hospitals in Egypt. The interviews were tape recorded and transcribed. Thematic analysis was conducted by 2 independent investigators. The findings highlighted that nurses did not perceive the benefits of hand hygiene, and that they linked the need to wash hands to a sense of dirtiness. Knowledge of hand hygiene and related products was limited and preference for water and soap was obvious. Environmental constraints, lack of role models and social control were identified as barriers for compliance with hand hygiene. A multi-faceted hand hygiene strategy was developed based on existing cultural concepts valued by the hospital staff

L'hygiène des mains du personnel de santé est l'une des interventions les plus importantes pour réduire la transmission des infections nosocomiales. Une étude qualitative visait à comprendre les determinants comportementaux de l'hygiène des mains afin d'établir des interventions durables pour la promotion de ce type d'hygiène dans les hôpitaux.Quatorze discussions thématiques en groupes ont été organisées avec le personnel infirmier dans deux hôpitaux universitaires en Egypte.Les entretiens ont été enregistrés puis retranscrits.Une analyse thématique a été menée par deux chercheurs indépendants. Les résultats ont mis en évidence le fait que le personnel infirmier ne percevait pas les avantages de l'hygiène des mains, et qu'il reliait le besoin de se laver les mains à une sensation de saleté. Les connaissances en matière d'hygiène des mains et des produits à utiliser étaient limitées et la préférence pour l'eau et le savon était marquée. Les contraintes environnementales, l'absence de modèles à suivre et de contrôle social ont été identifiés comme des obstacles au respect de l'hygiène des mains. Une stratégie d'hygiène des mains multidimensionelle a été mise au point à partir des concepts culturels existants qui étaient importants pour le personnel hospitalier

Synthesis of new benzofuran-1,3-thiazolidin-4-one derivatives from natural sources and study of their antioxidant activity.

Synthesis of benzofuran-1,3-thiazolidinone derivatives is described herein. These compounds were prepared via a concise and short route by condensation reaction of khellinone with aromatic/aliphatic amines followed by cyclization using thioglycolic acid. The newly synthesized compounds were characterized using the well known spectroscopic tools (IR, 1H NMR, and mass spectroscopy), as well as microanalysis. In frames of biological screening of the compounds, antioxidant activity was assessed in vitro.

Microscopic observation drug susceptibility assay in the diagnosis of multidrug-resistant tuberculosis.

BACKGROUND: Early detection of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is of primary importance for both patient management and infection control. Optimal methods for identifying MDR-TB in a timely and affordable manner in resource-limited settings are not yet available. OBJECTIVES: To evaluate the performance of a low-technology but rapid drug susceptibility testing method, the microscopic observation drug susceptibility assay (MODS), in the concurrent detection of M. tuberculosis and its susceptibility to isoniazid (INH) and rifampin (RMP) directly from sputum specimens. METHODS: A total of 115 smear-positive TB patients admitted to Abbasia Chest Hospital, Cairo, Egypt, were simultaneously tested using MODS and the BACTEC MGIT 960 mycobacterial detection system for the detection of M. tuberculosis and the identification of MDR-TB samples. RESULTS: MODS detected 112 (97.4%) samples and BACTEC MGIT detected 115 (100%). Of the 115 isolates tested for susceptibility to INH, RMP and MDR-TB, complete agreement between MODS and MGIT results was found among respectively 92.9%, 95.5% and 97.3% of samples. The sensitivity, specificity, and positive and negative predictive values of MODS in the detection of MDR-TB were respectively 95.3%, 98.6%, 97.6% and 97.1%. MODS results were obtained in a median of 8 days (range 5-21). CONCLUSION: MODS is an optimal alternative method for timely and affordable identification of MDR-TB in resource-limited settings.

Induction of T helper 1 response by immunization of BALB/c mice with the gene encoding the second subunit of Echinococcus granulosus antigen B (EgAgB8/2).

A pre-designed plasmid containing the gene encoding the second subunit of Echinococcus granulosus AgB8 (EgAgB8/2) was used to study the effect of the immunization route on the immune response in BALB/c mice. Mice were immunized with pDRIVEEgAgB8/2 or pDRIVE empty cassette using the intramuscular (i.m.), intranasal (i.n.) or the epidermal gene gun (g.g.) routes. Analysis of the antibody response and cytokine data revealed that gene immunization by the i.m. route induced a marked bias towards a T helper type 1 (Th1) immune response as characterized by high IFN-γ gene expression and a low IgG1/IgG2a reactivity index (R.I.) ratio of 0.04. The i.n. route showed a moderate IFN-γ expression but a higher IgG1/IgG2a R.I. ratio of 0.25 indicating a moderate Th1 response. In contrast, epidermal g.g. immunization induced a Th2 response characterized by high IL-4 expression and the highest IgG1/IgG2a R.I. ratio of 0.58. In conclusion, this study showed the advantage of genetic immunization using the i.m. route and i.n. over the epidermal g.g. routes in the induction of Th1 immunity in response to E. granulosus AgB gene immunization.

Synthesis of selenium-containing amino acid analogues and their biological study.

Synthesis of selenium-containing amino acid analogues is described. These compounds were prepared in a concise and short synthetic route in good yields by nucleophilic substitution reaction of pyridineselenol and quinolineselenol derivatives with N-phthaloylglycyl chloride followed by hydrazinolysis. The newly synthesized compounds were screened against different strains of bacteria and fungi.

Targeting NFĸB mediated breast cancer chemoresistance through selective inhibition of sphingosine kinase-2.

Resistance to chemotherapy remains a significant obstacle in the treatment of hormone- independent breast cancer. Recent evidence suggests that altered sphingolipid signaling through increased sphingosine kinase activity may be an important mediator of breast cancer drug resistance. Sphingosine kinase-1 (Sphk1) is a proposed key regulator of breast cancer tumorigenesis, proliferation and resistance. There is, however, conflicting data on the role of sphingosine kinase-2 (Sphk2) in cancer biology and resistance, with some suggesting that Sphk2 has an opposing role to that of Sphk1. Here, we studied the effects of the novel selective Sphk2 inhibitor, ABC294640 (3-(4-chlorophenyl)-adamantane-1-carboxylic acid (pyridin-4-ylmethyl) amide), on human breast cancer. ABC294640 blocked both viability and survival at low micromolar IC(50) concentrations in the endocrine therapy-resistant MDA-MB-231 and chemoresistant MCF-7TN-R cell systems. Treatment with the inhibitor significantly reduced proliferation, as seen in immunofluorescence staining of Ki-67 in vitro. Interestingly, pharmacological inhibition of Sphk2 induced apoptosis through the intrinsic programmed cell death pathway. Furthermore, ABC294640 also diminished NF-ĸB survival signaling, through decreased activation of the Ser536 phosphorylation site on the p65 subunit. Xenografts of MCF-7TN-R cells growing in immunocompromised mice were utilized to validate the therapeutic efficacy of the sphingosine kinase-2 inhibitor. Treatment with 50 mg of ABC294640/kg completely blocked tumor volume in this model. These results indicate that pharmacological inhibition of Sphk2 with the orally bioavailable selective inhibitor, ABC294640, has therapeutic potential in the treatment of chemo- and endocrine therapy- resistant breast cancer.

Angiogenesis in the caprine caruncles in non-pregnant and pregnant normal and swainsonine-treated does.

Microvascular corrosion casts of caruncles from non-pregnant and pregnant doe goats at 4, 7, 10, 13, 16, and 18 weeks were examined with scanning electron microscopy. The internal convex surface of the caruncles of non-pregnant does was covered with capillary meshes of regular diameter and form, without crypts. As pregnancy advanced the complexity of the vasculature increased: at 4 weeks the surface showed a pattern of ridges separated by troughs. At later stages, branches of radial arteries penetrated the periphery forming an extensive mesh of capillaries on the concave surface. Capillary diameters increased significantly during pregnancy, especially after 4 weeks, when large flattened sinusoids formed. These sinusoids had a great deal of surface area for potential contact with the fetal component. The caprine placenta is usually considered to have increased interhemal distance compared with endotheliochorial and hemochorial types: our results suggest that the very extensive development of sinusoids and crypts may compensate for any negative consequences of the placental architecture. Placental angiogenesis, which is physiologically normal, may serve as a general model of this process in other circumstances, such as tumor. The effect of swainsonine (active compound of locoweed and a potential anticancer drug) on vascular development showed no differences in sinusoidal diameters at 7 weeks, but a decrease in capillary density was noted. Swainsonine caused a great distortion to the vasculature at 18 weeks. The effects of this compound on the vascular development lend credibility to its potential as an anticancer agent.

Some predictions of the attached eddy model for a high Reynolds number boundary layer.

Many flows of practical interest occur at high Reynolds number, at which the flow in most of the boundary layer is turbulent, showing apparently random fluctuations in velocity across a wide range of scales. The range of scales over which these fluctuations occur increases with the Reynolds number and hence high Reynolds number flows are difficult to compute or predict. In this paper, we discuss the structure of these flows and describe a physical model, based on the attached eddy hypothesis, which makes predictions for the statistical properties of these flows and their variation with Reynolds number. The predictions are shown to compare well with the results from recent experiments in a new purpose-built high Reynolds number facility. The model is also shown to provide a clear physical explanation for the trends in the data. The limits of applicability of the model are also discussed.

First Report of the Pale Cyst Nematode, Globodera pallida, in the United States.

In 2006, a cyst nematode was discovered in tare dirt at a potato (Solanum tuberosum) processing facility in eastern Idaho. The nematode was found during a routine survey conducted jointly by the Idaho State Department of Agriculture and the USDA Animal and Plant Health Inspection Service through the Cooperative Agricultural Pest Survey program. Extensive additional sampling from two suspect fields led to the identification of the same nematode in a 45-acre (18.2-ha) field located in northern Bingham County. The morphology of cysts and second-stage juveniles and molecular analyses established the identity of the species as the pale cyst nematode Globodera pallida (Stone 1973) Behrens 1975. Morphological characters used for identification included cyst shape, characteristics of cyst terminal cone including nature of fenestration, cyst wall pattern, anal-vulval distance, number of cuticular ridges between anus and vulva, and Granek's ratio (1,4). The second-stage juvenile morphologies critical for identification were the following: body and stylet length, shape of stylet knobs, shape and length of tail and hyaline tail terminus, and number of refractive bodies in the hyaline part of tail (1,4). Diagnosis as G. pallida was clearly confirmed by two molecular tests. First, PCR-RFLP (restriction fragment length polymorphism) profiles of a ribosomal DNA fragment using restriction enzymes RsaI, TaqI, and AluI (2) were consistent with a G. pallida control and not G. rostochiensis. Second, the ribosomal DNA region that extends from the 3' end of the 18S ribosomal subunit and includes all of ITS1, 5.8S, and ITS2 to the 5' end of the 28S ribosomal subunit was used to generate sequence for the most accurate species determination. Sequences obtained from three individual juveniles were compared with those from several Globodera species (3), revealing unequivocal similarity to G. pallida. This detection represents a new country record for G. pallida in the United States. Collection of additional information regarding distribution of this nematode within the region is underway. References: (1) J. G. Baldwin and M. Mundo-Ocampo. Heteroderinae, Cyst- and Non-cyst-forming Nematodes. Pages 275-362 in: Manual of Agricultural Nematology. W. R. Nickle, ed. Marcel Dekker, New York, 1991. (2) V. C. Blok et al. J. Nematol. 30:262, 1998. (3) L. A. Pylypenko et al. Eur. J. Plant Pathol. 111:39, 2005. (4) A. R. Stone. Nematologica 18:591, 1973.

Anatomical, histological and genetic investigations of a sexually anomalous goat.

An apparently female goat was masculine in appearance and had strong male-pattern libido and behaviour. The goat's DNA was subjected to PCR analysis and its reproductive system was examined anatomically and histologically. The external genitalia consisted of an apparent vulva in the normal position and a grossly enlarged clitoris. Two masses could be palpated lying subcutaneously in the inguinal region; when they were removed they had the macroscopic appearance of hypoplastic testes, and histologically they had atrophic tubules and prominent interstitial tissues. To exclude sex chimaerism, X and Y chromosome-specific targets were amplified by PCR, using bone marrow and muscle DNA templates. The goat had some Y chromosome-specific sequences such as SRY and BRY.I but lacked others, such as BOV97M.

Evidence of the kappa1-1 law in a high-Reynolds-number turbulent boundary layer.

Dimensional analysis and overlap arguments lead to a prediction of a region in the streamwise velocity spectrum of wall-bounded turbulent flows in which the dependence on the streamwise wave number, kappa(1), is given by kappa(1)(-1). Some recent experiments have questioned the existence of this region. In this Letter, experimental spectra are presented which support the existence of the kappa(1)(-1) law in a high-Reynolds-number boundary layer. This Letter presents the experimental results and discusses the theoretical and experimental issues involved in examining the existence of the kappa(1)(-1) law and the reasons why it has proved so elusive.

Effect of herbizid and touchdown herbicides on soil fungi and on production of some extracellular enzymes.

Glucophilic and cellulose-decomposing fungi were significantly reduced in soil samples treated with 0.019-0.152 mg a.i./kg soil of the herbicides Herbizid and Touchdown. The decrease was regularly correlated with the doses of the two herbicides and persisted till the end of the experiment (12 weeks). The isolated fungi were found to be able to produce hydrolytic extracellular enzymes in solid media but with variable capabilities. The ability to produce enzymes was adversily affected by the incorporation of herbicides in culture media. Lower doses of herbicides were occasionally promotive to enzyme production and mycelial growth of some fungi. Incorporation of 50 ppm of Herbizid and Touchdown significantly activated amylase production and mycelial dry weight in cultures of Fusarium oxysporum, Mucor hiemalis and Penicillium chrysogenum. There was a significant increase in C1-cellulase produced by F. oxysporum and P. aurantiogriseum when cultures were treated with 50, 100 and 200 ppm of Herbizid which induced also more Cx-cellulase production by P. chrysogenum. Lipase and protease production was always lower in treated than in control fungal cultures.

Erectile dysfunction: anatomical parameters, etiology, diagnosis, and therapy.

Functional anatomy of the human penis involves various parameters: cavernous tissue, covering integument, prepuce foreskin, corpora cavernosa, corpus spongiosum, glans, facia, arterial supply, venous drainage, lymph drainage, musculature, and nerve supply. Several factors affect the expression/degree of erectile dysfunction (ED) endocrine profile, aging/senescence, demyelinating diseases, and surgery. Risk factors of ED are: age, vascular factors, metabolic diseases (diabetes mellitus), neurologic diseases, and HIV/AIDS. Several drugs are associated with ED: antiandrogenic, anticholinergic, antidepressants, antihypertensive, major tranquilizers, anxiolytics, and certain medicines/metabolites. The International Index of Erectile Function (IIEF) is a multidimensional scale for assessment of erectile dysfunction. The main structures mediating erection are the corpora cavernosa or "erectile bodies," which are fused distally for approximately three-quarters of their length. They separate proximally to fuse with each ischial tuberosity of the pelvis. On their ventral surface lies the corpus spongiosum, which surrounds the urethra. Coital dysfunction is classified into "erectile dysfunction" (psychosexual and endocrine/neuro-endocrine) and "ejaculatory dysfunction" (psychosexual, and genitourinary surgery). Vasculogenic impotence was evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Cavernosal, alpha-blockade is a technique used to evaluate and treat ED. Another diagnostic procedure for ED involves color floro and spectural Doppler imaging after papaverine-induced erection in impotent men. Color Doppler and duplex ultrasonography are used to evaluate Peyronie's disease. Sildenafil cilrate (Viagra) is an effective therapy of ED in men. Vardenavil is a highly selective phosphodiesterase 5 (PDE5) inhibitor which improved ED. Prostagland E1, vasoactive intestinal polypeptide (VIP), and phentolamine mesylate (administered by autoinjectors) have been applied to treat ED in patients resistant to other intracavernosal agents. Clinical trials were conducted on self-injection of vasoactive drugs, apomorphine SL, and tadalafil in diabetic men. Medical therapy of ED includes: medicated urethral system for erection (MUSE), intravenous pharmacotherapy, arterial revascularization, vacuum devices, two- and three-component inflatable penile prosthesis, semi-rigid penile prosthesis in situ, and inflatable one-piece penile prosthesis. Surgical therapy include procedures to correct Peyronie's penile deformity and penile deformity, procedures to avoid inevitable shortening accompanying Nesbit's disease, and for penile lengthening.