Background Chronic obstructive pulmonary disease (COPD) is a life-long disease affecting the airways. It occurs owing to long-term exposure to hazardous smokes and particles and leads to increased inflammatory response in the airway. Multiple well-recognized comorbidities are associated with COPD presence. Sexual affection is considered one of them through incompletely understood mechanism. Studies demonstrating erectile dysfunction (ED) prevalence among Egyptian patients with COPD are limited. Aim This study aimed to assess ED prevalence in male patients with a confirmed diagnosis of COPD and also to assess their serum testosterone level. Patients and Methods One hundred male patients with COPD and 40 age-matched healthy male controls were included in the study. Each participant was subjected to detailed medical history and full clinical examination, pulmonary assessment (pulmonary function tests by spirometry and arterial blood gas analysis), and measurement of total testosterone level. Also, each participant completed the Arabic version of the IIEF-5 questionnaire for assessment of erectile function and ED severity. Results The scores of the IIEF-5 questionnaire revealed that 71% of patients had ED of varying severity: 16% mild, 4% mild to moderate, 18% moderate, and 33% severe. Conclusion The results showed that patients with COPD also have ED of variable degrees. IIEF-5 scores negatively correlated with the age of the patients and the duration of COPD. Keywords: COPD, ED, IIEF-5, testosterone

Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity. Keywords: C-reactive protein, cytokines, interleukin-22, vitiligo

Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity. Keywords: C-reactive protein, cytokines, interleukin-22, vitiligo

Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity. Keywords: C-reactive protein, cytokines, interleukin-22, vitiligo

Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity. Keywords: C-reactive protein, cytokines, interleukin-22, vitiligo

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.