Objectives: This open label, phase I clinical trial (NCT02945462) using 2 consecutive intracavernous autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) for the first time in the treatment of diabetic patients with erectile dysfunction (ED). The primary outcome is to assess the safety and tolerability of intracavernous autologous BM-MSCs, the secondary outcome is to assess efficacy of the procedure. Patients and Methods: Four diabetic patients with refractory ED were included. Two consecutive intracavernous autologous BM-MSC injections were performed. Tolerability was assessed immediately and at 24 h, safety was evaluated for 2 years. Efficacy was assessed using International Index of Erectile Function-15 (IIEF-15) and Erection Hardness Score (EHS) for 12 months. Results: procedure was well tolerated and no patients reported significant adverse effects. There was significant improvement of IIEF-15 and EHS; IIEF-15 (p = 0.04), Erectile Function (p = 0.03), Sexual Desire (p = 0.04), Intercourse Satisfaction (p = 0.04), and Overall Satisfaction (p = 0.04). Conclusion: This is the first human study with proven tolerability, safety and efficacy of intracavernous autologous BM-MSC injections for treatment of diabetic patients with ED.

Background Lower urinary tract symptoms (LUTS) are prevalent among pregnant women. Several articles show the impact of LUTS on pregnant women’s quality of life (QoL). This study was designed to examine the impact of non-pathological LUTS on QoL among pregnant Palestinian women. Methods A cross-sectional, hospital-based study was conducted on women who were pregnant and receiving regular antenatal care at the obstetrics and gynecology clinic in Rafidia Hospital, Palestine. This self-administered questionnaire included the Urinary Distress Inventory – short-form (UDI-6), the Incontinence Impact Questionnaire – short-form (IIQ-7), the European Quality of Life scale – 5 dimensions (EQ-5D), and the European Quality of Life – visual analogue scale (EQ-VAS). A convenience sampling method was used. In addition to this, multiple linear regression analyses were performed aiming to identify variables that have a significant relationship with QoL (i.e. socio-demographic variables, UDI-6 score, and IIQ-7 score). Results This study included a total of 306 pregnant women. Participants had a mean age of 26.9 years (SD, 3.6). The subjects scored an average of 31.2 ± 19.2 out of 100 points for the UDI-6 scale and an average of 31.9 ± 24.9 out of 100 points for the IIQ-7 scale. On the other hand, the subjects’ average EQ-5D and EQ-VAS scores were 0.76 ± 0.17 and 67.96 ± 19.28 respectively. The subjects’ responses on UDI-6 significantly correlated with their responses on both the EQ-5D and EQ-VAS scales (r = − 0.338, p < 0.001 and r = − 0.206, p < 0.001, respectively). Likewise, their responses on IIQ-7 also significantly correlated with their responses on both the EQ-5D and EQ-VAS scales (r = − 0.389, p < 0.001 and r = − 0.329, p < 0.001, respectively). Regression analysis found that the UDI-6 score (p = 0.001) and IIQ-7 score (p < 0.001), were significantly and negatively associated with EQ-5D index scores. Conclusions Our study shows a remarkable correlation between LUTS and QoL among pregnant women. Further longitudinal studies are required to assess the status of LUTS in the pre-pregnancy stage to ascertain a more accurate assessment of LUTS or LUTS related intervention and its impact on QoL during pregnancy.

Background and Objectives: Coronavirus disease-2019 (COVID-19) is an emerging disease threatening the world with a rapid increase in cases and deaths since it was first identified in December 2019. Adequate knowledge, practice, and attitudes (KPA) toward COVID-19 among physicians at the frontline defense against the COVID-19 pandemic may enhance their ability to avoid the risk of self-infection, decrease mortality, and provide adequate medical care service in this pandemic. This study aimed to assess KPA toward COVID-19 among physicians in Jordan and Palestine. Methods: This is a cross-sectional study using an online survey conducted from 10 April to 26 April 2020 among Jordan and Palestine physicians. Invitations were sent to physician groups on Facebook and WhatsApp. This survey contains 36-items, divided into four main sections to assess the participants' socio-demographic characteristics, knowledge, practice, and attitude about COVID-19. Results: A total of 454 physicians participated in this study. The mean score of basic knowledge was 4.4 ± 0.8 (range 2-4). There were significant differences between basic knowledge mean scores among physicians in different professional degrees and physicians in various health sectors (P=0.0315, P=0.0137, respectively). The mean scores of selfprotection measures, were 6.1 ± 1.1 (range 3-7) and measures if physician self-suspected of COVID-19 were 9.9± 1.1 (range 5-11). The mean score of attitudes toward COVID-19 was 41.5 ± 3.3 (range 21-45) and significantly related to the age and different experience years (P=0.0022, P=0.0077, respectively). Conclusion:As the global threat of COVID-19 continues to emerge, physicians from Jordan and Palestine showed adequate KPA toward COVID-19. There was a significant difference in knowledge level and attitude between physicians. Policymakers and physicians should keep continuous educational activities, training, and follow-up updates during this pandemic.

Purpose Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC. Patients and Methods This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI. Results One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17; p <0.001). High CRP level is also significantly associated with EI (n=36; 86%; p <0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%; p <0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6–13mm), and HU density of stone of 700 (430–990) H.U ( p <0.001). Ureteric stone volume of 0.2 (0.06–0.3) cm 3 is significantly associated with EI ( p <0.001). Ureteral wall thickness of 3 (2–3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13–28 mm) are all significantly associated with a higher rate of EI ( p <0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI. Conclusion MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI.