Original Article / Research Article


Improvement of sperm function, chromatin damage, and oxidative damage by N-Acetyl cysteine in varicocelized rats model

Marziyeh Tavalaee, Maurizio Dattilo, Parisa Mohammadi, Mohammad Hossein Nasr-Esfahani

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e2

Introduction: N-Acetylcysteine (NAC), an acetylated form of the amino acid cysteine and precursor of reduced glutathione, plays important roles in a multitude of cellular processes, such as oxidative damage and detoxification of many electrophiles. Considering the pathophysiology of oxidative stress induced infertility in varicocele, we aimed to investigate the effect of NAC on semen analysis parameters (light microscopy), chromatin structure (aniline blue and acridine orange staining), and lipid peroxidation (BODIPY probe) in varicocelized rats.

Methods: In this experimental study, varicocelizing surgery was carried out on 30 Wistar rats. Ten of them were sacrificed after two months (one round spermatogenesis), together with control rats (n=10) and sham operated rats (n=10), to verify the varicocele model. Out of the remaining twenty varicocelized rats, ten received NAC while ten were treated with water (control group) for two months.

Results: All the investigational parameters (sperm parameters, chromatin integrity, and lipid peroxidation) severely worsened 2 and 4 months after surgical varicocele. The administration of NAC for two months significantly improved all the investigational parameters as compared to control rats at four months (p<0.05).

Conclusion: The supplementation of varicocelized rats with NAC was effective in antagonizing the damage as well as in preserving testicular structure and spermatogenetic function. These effects are likely to occur also in clinical varicocele.

marital satisfaction according to spouse’s smoking status

Amir Hosein Hasani Fard, Mostafa Hamdieh, Farhang Abed, Shiva Alikhani, Foojan Farahi, Mir Mehdi Chinifroush-asl

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e3

Introduction: One of the key aspects of mental health is one’s overall health and lifestyle. Longitudinal studies have shown that dissatisfaction with life causes long-term health damage and increases mortality, suicide tendency, unintentional injuries, disability at work, and diseases such as those of cardiovascular nature. Amongst all forms of satisfaction, that of marital is of utmost importance. On a separate note, inhalation of cigarette smoke exposes passive smokers to many chemical and toxic carcinogens, and it can negatively affect the non-smokers present. Furthermore, in psychiatric counseling sessions, many women report that they hate smoking. If we can show that inhaling cigarette smoke in men can have an impact on marital satisfaction, it can increase the consistency of family foundations and have positive effects on the health and spirit of family members by informing families. Methods: In this study, 200 housewives, who had smoking husbands that smoked at home, were subjected to pre-determined conditions, alongside 200 housewives who had non-smoking husbands and were therefore not exposed to smoking by their husbands at home. They were divided into two groups and were assessed by Marital Conflict Questionnaire (MCQ). For a closer look at the level of marital satisfaction, the questionnaire results were divided into three subgroups which were marked as low, moderate, and good. Results: After calculating the total score of the questionnaire and statistical analysis, the results showed a higher rate of marital satisfaction in women who had non-smoking husbands compared to those who had smoking husbands and this difference was considered significant at P-value <0.001. Conclusion: Inhaling cigarette smoke in men in the family environment may seem to make a good impression on the smokers, but as the results of our study suggest, it also has adverse effects on marital satisfaction.

Five-year Survival Rate of Prostate Cancer in Iran: Results of the national cancer-registry system during 2010-2015

Fereshte Aliakbari, Mohammad Ali Ghanbari, Maryam Khayamzadeh, Mohammad Reza Hajian, Farzad Allameh, Mahsa Ahadi, Zahra Sadeghzadeh, Mohammad Esmaeil Akbari, Mohammad Solimani, Shahrzad Nematollah

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e4

Background: Prostate Cancer is recognized as the second cause of death due to cancers among men worldwide. Due to the lack of local evidence on the survival rate of patients with prostate cancer, this study aimed to estimate the 5-year survival rate of patients afflicted with this condition in Iran. Materials and Methods:  This study made use of information on 9,772 prostate cancer cases who were registered in the National Cancer Registry during 2010-15. A telephone survey, with a response rate of 35%, was conducted to gather additional information such as death status, demographic characteristics, and clinical profile. Kaplan-Meier estimates was used to estimate five-year survival rates. Results: The overall five-year survival rate of prostate cancer was 82% (95% CI: 80-83%).  Significantly higher five-year survival rates were observed among retired patients (rate: 94%,95%CI: 92-96), patients receiving a combination of radiotherapy and surgery (rate: 92%,95%CI: 89-94), and patients residing in rural areas (rate: 92%, 95%CI: 90-93). Conclusion: We found that various factors such as occupation, area of residence, and the type of medication, may influence on survival rate of prostate cancer. Careful evaluation and understanding of effective factors are required to adopt proper health policies and treatment options. Due to the importance of etiologic and epidemiological data, inclusion of such data into the national registry system for Prostate Cancer is strongly recommended.

Effect of excessive Arm Swing on Speed and Cadence of walking

Razieh Yousefian Molla, Heydar Sadeghi, Farzam Farahmand, Mohammad Ali Azarbayjani

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e5

Introduction: One of the changes in the movement patterns that can be seen in upper limb swing is the excessive increase in upper limb movement and swing during walking. As temporal parameters such as cadence and speed in stationary and mobile environments can be equally used to determine early fall potentials, Therefore, this study aims to investigate the effect of excessive arm swing on speed and cadence of walking. Material and Methods: 30 healthy subjects were exposed to Vicon 10 motion capture system analysis and were asked to first walk normally at normal speeds and then move their hands excessively while walking at the same speed. The temporal data were extracted and analyzed by Matlab software. Descriptive (mean, SD) and Shapiro-Wilk test for normality of data distribution, and paired sample t-test were used to compare the patterns. Results: there was a significant difference in cadence and speed variables, between the means of natural arm swing and excessive arm swing modes (p ≤ 0.05). Conclusion: Given these results, it should be considered that the effects of upper limb pattern changes on the lower limbs and gait can compensate for the lack of attention to movement and pattern of upper extremity positioning during walking.

Introduction: It is very important to prevent Sexually Transmitted Diseases (STIs) as they cause many other health problems with serious complications. In fact, prevention is the most effective mean of dealing with STIs. In saying that, the basic requirements of prevention include appropriate health education on the subject. This study compares the effectiveness of two health education programs regarding bacterial STIs among male students at Nursing and Medical Schools of Shahid Beheshti University of Medical Sciences and Health Services in Tehran. Materials and Methods: The quasi-experimental study included 430 male students aged between 18 and 30 who were majoring in nursing and medical field. Two faculties were selected through purposeful non-random sampling.  A valid and reliable researcher-made questionnaire was filled out in two steps (before and one month after the training). The training interventions in direct education group included a lecture along with a session of questions and answers (Q&As) for one and a half hours. On the other hand, the indirect education only included a weblog on the topic of STIs. The statistical tests were employed to analyze the collected data in SPSS 22. Results: Generally, students’ knowledge and attitudes toward this subject were at a moderate level before the intervention, and only %18.4 of them were well-aware of bacterial STIs. In fact, %44 of the respondents had positive attitudes toward those diseases. The research results indicated that the educational intervention managed to increase the awareness and attitudes of the students in relation to STIs in the two case groups in comparison with the control group. However, the different methods of education produced similar results and had no significant differences. Moreover, attitudes increased in the weblog group slightly more than the lecture group. Conclusion: According to the findings of this research, The weblog intervention had more effects on their attitudes than the lecture intervention. Therefore, the modern training method based on the use of the internet (weblog) can be used effectively as an alternative or supplement to traditional training methods.

The prevalence of urinary incontinence following radical prostatectomy and its related factors: A national registry based study

Farzad Allameh, Fereshte Aliakbari, Shahrzad Nematollahi, Mehdi Dadpour, Arash Ranjbar, Mohammad Javad Eslami, Jalil Hosseini, Mohammad Ali Ghanbari

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e7

Introduction: The purpose of this paper is to evaluate the prevalence and the risk factors of urinary incontinence following radical prostatectomy in Iranian population. This study is conducted based on the available data from the National Cancer Registry. Materials and Methods: In this retrospective study, we extracted the information of all the patients with organ-confined prostate cancer who underwent radical prostatectomy from 2010 to 2014. All the patients were interviewed face to face or via telephone to collect additional data. Urinary incontinence was evaluated by a questionnaire using the definition based on pads use. The effects of risk factors were evaluated using logistic regression models. Results: The details of 13,583 registered patients with prostate cancer were collected. Overall, the prevalence of urinary incontinence was estimated as 10.5% (n=1424). It is important to mention that the highest proportion of cases with urinary incontinence belonged to the age group of 71-80 years old (n=502, 35.2%), as well as patients with elementary education (n=458, 32%) or no education at all (n=333,23.5%). Furthermore, more cases lived in urban settings (n=1159,81.7%), one-fourth of them (n=365) smoked tobacco, and nearly 11% of them reported having been diagnosed with diabetes (n=152). The odds of having urinary incontinence increased by 20% in patients who had undergone radiotherapy as part of their treatment for prostate cancer (AOR=1.20, 95%CI: 1.07,1.36). Conclusion: We estimated the prevalence of urinary incontinence after radical prostatectomy as 10.5% among prostate cancer patients. We found that having been exposed to education, having been diagnosed with diabetes, and receiving radiotherapy, are amongst the significant risk factors for urinary incontinence. We also suggested that more predictor variables should be recorded in the National Cancer Registry.

Comparison of Lasix and Methyldopa in Controlling Hypertension in preeclampsia patients: A Double-Blind Randomized Clinical Trial

Setareh Siamansoori, Elahe Afshari, Maryam Palizdar, Mohammad Ali Hosseini

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e10

Introduction: Preeclampsia is a specific gestational syndrome that reduces organ perfusion due to vascular spasm and endothelial activation. Despite the use of magnesium sulfate, the patient's blood pressure sometimes remains uncontrolled, and therefore, it is necessary to use other medications, especially diuretics and Methyldopa. Hence, the aim of this study was to compare Lasix and Methyldopa in controlling postpartum hypertension in preeclampsia patients after magnesium sulfate treatment. Material and Methods: This double-blind randomized clinical trial was carried out on 100 women with preeclampsia referred to Akbar Abadi Hospital-Iran. In the first 24 hours after the termination of pregnancy, the participants’ blood pressure was measured and those with a blood pressure of 140/90 to 160/100 were divided into two groups. In the first and second 24 hours, and then one week after the intervention, systolic and diastolic blood pressure as well as diuresis and drug complications in the two groups were assessed and compared.  The present study was registered in the Iranian Registry of Clinical Trials (IRCT) under the ID of IRCT20180114038349N1. Results: The mean age of individuals was 29.93 ± 6.65 in the Methyldopa group, and 32.35 ± 4.85 in the Lasix group (P = 0.479). Systolic and diastolic blood pressure had a substantial reduction in both groups, but there was no significant difference between the two groups (P> 0.05). Systolic blood pressure was reduced by 31 mmHg (reduction from 146 to 115) in the methyldopa group and 30 mmHg (reduction from 145 to 114) in the Lasix group. Furthermore, the reduction in diastolic blood pressure was 25 mmHg (from 95 to 70) in the methyldopa group, and 21 mmHg in the Lasix one (from 91 to 70). Conclusion: The present study showed that using Lasix and methyldopa was effective enough in changing blood pressure in patients with preeclampsia, and the effects observed in the two groups were the same. Therefore, it could have a great impact on the wellbeing of couples.

Different Aspect of Transperitoneal Laparoscopic Pyelolithotomy for Management of Pelvic Stones Larger than 20 mm: a Cuasi-Experimental Study in Male Patients

Hamid Pakmanesh, Mahboubeh Mirzaei, Sohrab Mohammad_Salehi, Rayka Sharifian

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e13

Background: We study different aspect of laparoscopic pyelolithotomy (LP) in patients with large renal pelvis stone regarding success rate, complications as well as the recurrence free status.


Material and methods: From July 2015 to January 2019, 32 patients underwent LP for single large renal pelvis stone ($\ge$2 cm). Patient characteristics, preoperative and postoperative hemoglobin, creatinine as well as possible complications based on Clavien classification were recorded. Stone free status was evaluated using computed tomography scan one month after the surgery. Any particle bigger than 4 mm was considered as significant residual stone. During the next one years after the operation, renal ultrasonography was performed for all patients every six month to find any stone recurrence.


Results: Mean operation time was 134.55$\pm$31.41 minutes. Patients were hospitalized 3.36$\pm$1.13 days in the LP group. Patients showed hemoglobin decrease of 1.50$\pm$1.05 (P=0.2). Stone free rate was 93.75\% and Mean overall stone free status estimated to be 32 months.


Conclusion: PCNL has been the treatment of choice for large renal pelvis stones; however, in expert hands, LP is an appropriate substitute with superior stone free rate, less bleeding and remarkably less stone recurrence.

Prostate-Specific Antigen Levels Among Diabetic Men: Exploring Patients Attending Outpatient Clinic in Yemen

Nazeh Al-abd, Mohammed Alshakka, Mohamed Izham Mohamed Ibrahim

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e14

Introduction: It has been reported that patients with diabetes have a decreased risk for developing prostate cancer. The study aimed to measure Prostate-specific antigen (PSA) levels among diabetic men who had not previously been diagnosed with prostate cancer. Materials and Methods: A cross-sectional study was carried out in public hospitals among diabetic men in Aden, Yemen. A predesigned structured questionnaire, including the personal data as well as physical and clinical characteristics of the study population, such as height, weight, smoking status, the duration of diabetes, and the type of treatment, was included. Blood samples were collected from the respondents, and the levels of fasting blood glucose (FBG) and PSA were measured. The data were analyzed using descriptive and inferential statistics. Results: A total of 145 diabetic male patients were included in this study. The mean PSA level of the respondents was 2.56 ng/ml. There were significant differences in PSA levels according to patient age (p=0.000). The elderly patients exhibited significantly higher PSA levels than the younger groups. The PSA levels of smokers (2.60±0.48 ng/ml) were significantly higher (p=0.035) than those of nonsmokers (2.45±0.65 ng/ml). However, no significant difference was found in PSA levels according to body mass index (BMI) category, the type of treatment, or the duration of diabetes. Additionally, our results showed that PSA levels were not significantly correlated with FBG levels. Conclusion: PSA levels were associated with age and smoking status, but not with BMI, the type of diabetic treatment, the duration of diabetes, or with FBG levels.

Letter to the editor


Post-syncope trauma should be considered in COVID-19 patients

Fatemeh Ghanbarpour, Seyed Mohammad Ghahestani, Rayka Sharifian

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e11

In December  2019, a new form of respiratory infection associated with coronavirus appeared in Wuhan, China. As of today, COVID-19 has spread all around the world. There have been 9.24 million confirmed cases and 477,000 deaths globally. Fever, cough, and coexistence chest or back pain are some of the most reported symptoms of COVID-19. Although syncope is not a primary symptoms, we see patients passing out in the street after coronavirus pandemic. Up to now, syncope due to COVID-19 has only been reported by CHANTAL and coauthor in a 79 year-old patient. (1) There is no available data on syncope in COVID-19 patients. This is while some patients have been referred to us purely for their symptoms of fainting. Etiology of fainting in COVID-19 may be the product of orthostatic hypotension and vasovagal syncope due to dehydration. Increasing pressure in thoracic cavity during sequential cough may induce “cough syncope”

Review Article


Why are Men more susceptible to COVID-19: A narrative review of current global knowledge

Shahrzad Nematollahi, Samira Shariatpanahi, Mohammad Reza Hosseini, Alireza Fatemi

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e1

Since its inception on December 2019, COVID-19 epidemic now has been titled a global emergency. Rich literature on the global descriptive epidemiology of the cases has shown that the burden of COVID-19 epidemic in terms of both morbidity and mortality is more pronounced among men. Physiological and genetic traits along with numerous differences in social and cultural profile of men are attributed to this discrepancy. This review attempted to delineate various proposed explanations for the observed gender-differences in COVID-19 morbidity and mortality.

Predictors of sperm retrieval with micro TESE, A narrative review article

Amir Reza Abedi, Saeed Montazeri, Saleh Ghiasy, Ferershte Aliakbari

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e8

Introduction: Regarding the financial and psychological effects of micro-TESE on patients with NOA, it is important to determine the parameters by which the sperm retrieval with micro-TESE can be predicted. Methods: The key words used for conducting a search in the PubMed database included nonobstructive azoospermia and TESE. The abstracts of the articles were reviewed, and the articles which reported the parameters’ influence on sperm retrieval with micro TESE were included. All non-English papers, case reports, and case series, were excluded from the review. Eventually, 25 articles were selected to be included. Results:  It is recommended that diagnostic test is biopsy should be performed at the time of micro-TESE. The histopathology of testis, testicular volume, hormone profile, aging, and genetic factors, are parameters that might influence the results of sperm retrieval with micro-TESE. Heterogeneous histopathological pattern and report of hypospermatogenesis on pathology, lower serum FSH level, normal testis volume, and varicocelectomy, increase the chance of sperm retrieval with micro-TESE. In terms of sperm retrieval, some genetic factors such as AZFa, AZFb, and chromosome Y micro deletion provide poor prognosis. Conclusion: Testis histopathology is the most important factor which predicts sperm retrieval with micro-TESE. Other factors that influence the sperm retrieval rate are testis volume, genetic factor, serum FSH level, and history of varicocelectomy.

Challenges of disinfection by-products in water and effect on the men's health infertility- A Narrative review

Laleh R,Kalankesh, Reza Kheirandish, Shahrzad Nematollahi, Jalil Hosseini, Maedeh Esmailli, Fereshteh Aliakbari

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e9

Chlorination is the most common disinfectant in the water treatment process. The reaction between Natural Organic Matter (NOM) in water and chlorine lead to the formation of harmful disinfectant by-products (DBPs). The most common DBPs (HAAs and THMs) impose risks on human health. The data acquired from human samples on the relationship of men's infertility with DBPs exposure are limited and epidemiological studies have reported various results about the association between long-term exposure to DBPs and the adverse effect on the man's infertility (sperm concentration, semen quality and sperm motility). Previous cellular studies show that HAAs and THM damaged DNA by their effect on the ROS generation and Oxidative stress, respectively. Moreover, CDBM can lead to decreased litter sizes and pup viability. Bromodichloromethane (BDCM) cause the production of sperm abnormalities. In addition, Trichloromethane (TCM) led to increase the degeneration of epididymis ductal epithelium. Dibromoacetic acid (DBAA) and Bromochloroacetic acid (BCAA) led to synergistical decrease in the levels of SP22 sperm membrane protein. Likewise, BCAA and DBAA resulted in testicular damage. It should be noted that synergistic effect between Br THMs and TCAA in relation to below-reference sperm count was demonstrated. It has been reported that mixture of THMs and HAAs lead to increase sperm motility in adult male rats.

Association of Genetics traits with obesity in men: A review on the current knowledge in Iran

Arezoo Akhoundi Khoranaghi, Shahrzad Nematollahi, Fereshteh AliAkbary, Samira Shariatpanahi

Men's Health Journal, Vol. 4 No. 1 (2020), 19 April 2020 , Page e12

Today, obesity is one of the leading causes of death. It also causes other diseases such as diabetes, cardiovascular disease, and various types of cancer. Obesity is a multifactorial disease caused by factors such as genetics and lifestyle. However, scientists imagine that about 40-70% of the disease originates from genetics. In this review, we examined the role of different genes in obesity by examining 30 articles published on the role of genetics in the obesity of Iranian men, according to their BMI, comorbidities and family history. We concluded that most of the research has been done on the FTO, Hind III and S447 genes. We also showed an apparent relationship between these genes and obesity. Finally, according to studies, FTO can be considered as the most important and strongest contributor to obesity.